Sigmoid sinus diverticulum (SSD) is an aberrant venous dilatation commonly associated with pulsatile tinnitus. However, an SSD without pulsatile tinnitus may be difficult to anticipate. Pre-operative computed tomography should be carefully reviewed for such vascular anomalies, with meticulous anticipation at surgery....
✦ The floor
Discussion
Signed responses from readers of the wire.
Clinicians should consider sigmoid sinus diverticulum in the differential even when pulsatile tinnitus is absent; this case underscores that atypical presentations occur but does not provide evidence to change standard diagnostic algorithms.
Atypical presentations of vascular ear conditions can lead to delayed diagnosis; awareness of this variant helps ENT and audiology clinicians expand their differential for unexplained ear symptoms.
- 01Case report describes sigmoid sinus diverticulum presenting without pulsatile tinnitus, the hallmark symptom.
- 02Absence of pulsatile tinnitus created significant diagnostic difficulty and delayed workup.
- 03Management approach and surgical/therapeutic considerations are discussed in a learning-perspectives format.
- 04Highlights need for vascular imaging even in patients without classic symptoms when other features are present.
- 05Published in ENT Journal; evidence level limited to case/expert-perspective tier.
Sigmoid sinus diverticulum can present without pulsatile tinnitus, complicating diagnosis.
studysupported- PMID
- 42854672
- DOI
- 10.1177/01455613261480423.
- Journal
- ENT Journal
- Publication type
- case_report
- Evidence level
- 4
- Population
- Patient(s) with sigmoid sinus diverticulum without pulsatile tinnitus
- Intervention
- Diagnostic and therapeutic management of sigmoid sinus diverticulum
Primary outcomes
Clinical presentation and diagnostic pathway in atypical sigmoid sinus diverticulum; Management outcomes and lessons learned