Sigmoid sinus dehiscence resurfacing as treatment for pulsatile tinnitus

To report a case of sigmoid sinus dehiscence presenting with pulsatile tinnitus and treated successfully with resurfacing. This patient presented with pulsatile tinnitus due to sigmoid sinus dehiscence. This was successfully treated using only soft tissue resurfacing. Sigmoid sinus dehiscence is a rare but treatable cause of pulsatile tinnitus. It can occur in the absence of a diverticulum, and is not necessarily limited to the transverse sigmoid junction. When resurfacing, care must be taken not to significantly alter the extraluminal diameter of the sigmoid in a dominant sinus, as this raises the risk of post-operative hydrocephalus.