Application of endovascular coiling and stent in pulsatile tinnitus caused by jugular bulb diverticulum: A case report

Pulsatile tinnitus is a rare otologic symptom that presents a diagnostic and management dilemma for experienced otolaryngologists. Treatment options range from conservative management to surgery, but patients may not be able to tolerate symptoms with the former and the latter procedure may be associated with significant morbidity We describe the case of using a stent-assisted coil approach to treating a patient with jugular bulb diverticulum (JBD) and severe pulsatile tinnitus. We describe a 41-year-old woman who presented with disabling pulsatile tinnitus due to right JBD. Both surgical or endovascular approaches were possible, but we decided to treat the diverticulum with coil emboli-zation and stenting of the jugular bulb. Following the procedure, tinnitus presence and severity were self-reported or assessed using the tinnitus handicap inventory (THI) and tinnitus magnitude index (TMI). The total score of both THI and TMI improved in 6 months after surgery, and there was no complication. Therefore, we report this experience, which was resolved through successful endovas-cular coiling and stent procedure for severe pulsatile tinnitus with no complication.