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

Background: 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. Materials and methods: PubMed, Embase, Scopus, and Web of Science were systematically searched for studies reporting endovascular treatment of pulsatile tinnitus caused by venous sinus diverticula. Eligible observational studies, case series, and case reports were selected using a Population-Concept-Contextframework. Data extraction and screening were independently performed by multiple reviewers, and findings were synthesised descriptively with quality appraisal to contextualise the evidence. Results: A total of 23 studies comprising 78 patients were included, predominantly single-centre case reports ( Conclusion: Endovascular treatment shows high symptomatic response rates in selected patients with venous sinus diverticulum-related pulsatile tinnitus, but evidence is limited by small retrospective studies and heterogeneous reporting of outcomes. Prospective studies with standardised diagnostics and validated tinnitus measures are required.