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Focal defect of mastoid bone shell in the region of the transverse-sigmoid junction: a new cause of pulsatile tinnitus

Published online by Cambridge University Press:  07 February 2012

J Xue
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
T Li
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
X Sun
Affiliation:
Department of Medical Imaging, Peking University First Hospital, Beijing, China
Y Liu*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
*
Address for correspondence: Dr Yuhe Liu, Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, No 8 Xishiku Street, Western District, Beijing 100034, China Fax: +86 10 66551057 E-mail: liuyuhefeng@163.com

Abstract

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.

Participants and intervention:

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.

Conclusion:

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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