Focal defect of mastoid bone shell in the region of the transverse-sigmoid junction: a new cause of pulsatile tinnitus.
OBJECTIVE
Pulsatile tinnitus usually originates from vascular structures, causing an arterial or venous bruit. We report a new cause of pulsatile tinnitus: a focal defect of the mastoid bone shell in the region of the transverse-sigmoid junction, with a normal transverse-sigmoid sinus.


METHODS
Three patients complained of unilateral, pulsatile tinnitus present for many years. They were identified as having a focal defect of the mastoid bone shell in the region of the transverse-sigmoid junction. The patients underwent transmastoid reconstruction of the mastoid bone shell overlying the transverse-sigmoid sinus.


RESULTS
All three patients reported immediate resolution of their symptoms, and were asymptomatic at final follow up.


CONCLUSIONS
A focal defect of the mastoid bone shell overlying the transverse-sigmoid sinus, with no abnormality of the sinus itself, may be a new cause of pulsatile tinnitus. Surgical reconstruction of the mastoid bone shell overlying the transverse-sigmoid sinus can provide lasting symptom relief for patients with pulsatile tinnitus and computed tomographic evidence of the defect.
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China.
J
J
Xue
T
T
Li
X
X
Sun
Y
Y
Liu
D000328:Adult; D001299:Audiometry; D005260:Female; D006801:Humans; D008416:Mastoid / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D011859:Radiography; D014012:Tinnitus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D054064:Transverse Sinuses / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome