Endovascular treatment of pulsatile tinnitus associated with venous sinus diverticulum: a scoping review

Venous sinus diverticula are a recognised and potentially treatable cause of pulsatile tinnitus. While surgical resurfacing has traditionally been employed, a range of endovascular approaches-including coil embolization, venous sinus stenting, and intrasaccular devices-have emerged as less invasive alternatives. The scope and quality of evidence supporting these interventions, however, remain poorly defined.

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Audiologists should be aware that pulsatile tinnitus caused by venous sinus diverticulum has a defined surgical pathway; refer promptly to neurovascular specialists when this etiology is suspected rather than managing symptomatically.

Clarifying the comparative effectiveness of endovascular versus surgical approaches for a treatable cause of pulsatile tinnitus could shorten the diagnostic odyssey for affected patients.

1. 01Scoping review covers endovascular treatment of pulsatile tinnitus from venous sinus diverticula.
2. 02Endovascular approaches are compared with traditional open surgical resurfacing.
3. 03Pulsatile tinnitus from venous sinus diverticulum is a structural, potentially curable cause.
4. 04Early neurovascular referral is implicitly supported for suspected vascular pulsatile tinnitus.
5. 05Evidence base is scoping-level; robust RCT-level evidence is lacking.

PMID

42639145

DOI

10.3389/fsurg.2026.1859104.

Journal

Frontiers in Surgery

Publication type

review

Evidence level

5

Population

Patients with pulsatile tinnitus caused by venous sinus diverticulum undergoing endovascular or surgical treatment.

Intervention

Endovascular treatment of venous sinus diverticulum

Comparator

Traditional surgical resurfacing