{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:23:58Z","timestamp":1794324238219,"version":"4.9.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>A dominant sigmoid sinus with focal dehiscence or thinning (DSSD\/T) of the overlying bony wall is a commonly encountered, but frequently overlooked, cause of vascular pulsatile tinnitus (VPT). Also, the pathophysiological mechanism of sound perception in patients with VPT remains poorly understood. In the present study, a novel surgical method, termed transmastoid SS-reshaping surgery, was introduced to ameliorate VPT in patients with DSSD\/T. The authors reviewed a case series, analyzed the surgical outcomes, and suggested the pathophysiological mechanism of sound perception. The theoretical background underlying VPT improvement after transmastoid SS-reshaping surgery was also explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Eight patients with VPT that was considered attributable to DSSD\/T underwent transmastoid SS-reshaping surgery between February 2010 and February 2015. The mean postoperative follow-up period was 9.5 months (range 4\u201313 months). Transmastoid SS-reshaping surgery featured simple mastoidectomy, partial compression of the SS using harvested cortical bone chips, and reinforcement of the bony SS wall with bone cement. Perioperative medical records, imaging results, and audiological findings were comprehensively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In 7 of the 8 patients (87.5%), the VPT abated immediately after surgery. Statistically significant improvements in tinnitus loudness and distress were evident on numeric rating scales. Three patients with preoperative ipsilesional low-frequency hearing loss exhibited postoperative improvements in their low-frequency hearing thresholds. No major postoperative complications were encountered except in the first subject, who experienced increased intracranial pressure postoperatively. This subsided after a revision operation for partial decompression of the SS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Transmastoid SS-reshaping surgery may be a good surgical option in patients with DSSD\/T, a previously unrecognized cause of VPT. Redistribution of severely asymmetrical blood flow, reinforcement of the bony SS wall with bone cement to reconstruct a soundproof barrier, and disconnection of a problematic sound conduction route via simple mastoidectomy silence VPT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.6.jns15961","type":"journal-article","created":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T10:02:29Z","timestamp":1452247349000},"page":"441-449","source":"Crossref","is-referenced-by-count":43,"title":["Transmastoid reshaping of the sigmoid sinus: preliminary study of a novel surgical method to quiet pulsatile tinnitus of an unrecognized vascular origin"],"prefix":"10.3171","volume":"125","author":[{"given":"Chong Sun","family":"Kim","sequence":"first","affiliation":[{"name":"Seoul National University College of Medicine;"},{"name":"Soree Ear Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunseok","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja-Won","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Young","family":"Yoo","sequence":"additional","affiliation":[{"name":"Myungdong Yonsei ENT Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwang Seok","family":"An","sequence":"additional","affiliation":[{"name":"Graduate School of Convergence Science and Technology, Seoul National University, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyogu","family":"Lee","sequence":"additional","affiliation":[{"name":"Graduate School of Convergence Science and Technology, Seoul National University, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inyong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns15961","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1002\/lary.24822","article-title":"What is the best imaging modality in evaluating patients with unilateral pulsatile tinnitus?","volume":"125","author":"Ahsan","year":"2015"},{"key":"b2-jns15961","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","article-title":"Tinnitus","volume":"382","author":"Baguley","year":"2013"},{"key":"b3-jns15961","series-title":"Arch Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1001\/archotol.126.2.137","article-title":"Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey","volume":"126","author":"Carey","year":"2000"},{"key":"b4-jns15961","series-title":"Acta Otolaryngol","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3109\/00016489.2011.631190","article-title":"3-dimensional reconstruction of the venous system in patients suffering from pulsatile tinnitus","volume":"132","author":"Cho","year":"2012"},{"key":"b5-jns15961","series-title":"Otol Neurotol","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1097\/MAO.0b013e31822a1c7d","article-title":"Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings","volume":"32","author":"Eisenman","year":"2011"},{"key":"b6-jns15961","series-title":"Interv Neuroradiol","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1177\/159101990901500409","article-title":"Successful endovascular treatment of pulsatile tinnitus caused by a sigmoid sinus aneurysm. 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