• J Xue, T Li, X Sun, and Y Liu.
• Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China.
• J Laryngol Otol. 2012 Apr 1; 126 (4): 409-13.

ObjectivePulsatile 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 InterventionThree 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.ResultsAll three patients reported immediate resolution of their symptoms, and were asymptomatic at final follow up.ConclusionA 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.

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