IntroductionSigmoid sinus diverticulum (SSD) has been increasingly reported as a cause of pulsatile tinnitus (PT). While both endovascular and surgical treatments have been used, there is a lack of consensus on the treatment modality to treat SSD. We conducted a systematic review of the available literature to compare the clinical outcomes and safety of endovascular versus surgical approaches for treating SSD.MethodsA systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify studies encompassing the management of SSD. Studies reporting the clinical outcomes and safety of endovascular or surgical treatments for SSD between January 2000 and January 2023 were included. Results were characterized using descriptive statistics.ResultsEndovascular treatment (EVT) was reported by 17 articles, yielding 26 patients with 27 diverticula. Surgical treatment was reported by 20 articles, yielding 105 patients with 107 diverticula. EVT led to complete or near-complete resolution in all patients with SSD and PT. Complications occurred in 3.7% (1/27) with a return to baseline after 2 months. There were no permanent complications from EVT. Surgical treatment resulted in complete resolution in 77.6% (83/107) of cases, incomplete resolution in 11.2% (12/107), and no resolution in 11.2% (12/107). Significant complications occurred in 9.3% (10/107) of the surgical-treated patients.ConclusionEVT in patients with PT and venous diverticulum appears more effective and safer than surgical treatment, but large studies are lacking. Studies directly comparing endovascular and surgical treatment are needed.

中文翻译：

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乙状窦憩室引起搏动性耳鸣的血管内治疗与手术治疗：系统评价

简介乙状窦憩室（SSD）越来越多地被报道为搏动性耳鸣（PT）的原因。虽然血管内治疗和手术治疗都已被使用，但对于治疗 SSD 的治疗方式缺乏共识。我们对现有文献进行了系统回顾，以比较血管内治疗与手术治疗 SSD 的临床结果和安全性。方法根据系统回顾和荟萃分析的首选报告项目进行系统回顾，以确定涵盖 SSD 管理的研究。其中包括报告 2000 年 1 月至 2023 年 1 月期间 SSD 血管内或手术治疗的临床结果和安全性的研究。使用描述性统计对结果进行表征。结果 17 篇文章报道了血管内治疗 (EVT)，其中 26 名患者有 27 个憩室。 20 篇文章报道了手术治疗，共治疗了 105 名患有 107 个憩室的患者。 EVT 使所有 SSD 和 PT 患者完全或接近完全缓解。 3.7% (1/27) 发生并发症，2 个月后恢复到基线。 EVT 没有造成永久性并发症。手术治疗使 77.6% (83/107) 的病例完全消退，11.2% (12/107) 的病例完全消退，11.2% (12/107) 的病例未消退。 9.3%（10/107）的手术治疗患者出现明显并发症。 结论 PT合并静脉憩室患者的EVT似乎比手术治疗更有效、更安全，但缺乏大规模研究。需要直接比较血管内治疗和手术治疗的研究。