Clinical data of 25 patients with venous pulsatile tinnitus were analyzed. During surgery, a small incision was made in the posterior auricular region under local anesthesia, and mastoid exploration plus sigmoid sinus constriction or sigmoid sinus retraction were performed. The tinnitus evaluation questionnaire (TEQ) was used to quantify improvement in tinnitus after the operation (1st, 3rd, and 6th months). The preoperative hearing test results were compared with those obtained in the 1st month postoperatively to determine whether the surgery had adverse effects on hearing.

As reported by the patients, pulsatile tinnitus had disappeared during the follow-up period in 21 patients. Four patients had mild pulsatile tinnitus in the 6th month postoperatively; however, this conscious tinnitus did not affect the patients’daily lives. The preoperative TEQ score of the patients was 10.44±3.08. The postoperative TEQ scores in the 1st, 3rd, and 6th months were 3.68±1.75, 2.76±1.23, and 2.72±1.17, respectively, which were significantly lower than the preoperative TEQ score. The postoperative TEQ scores in the 3rd and 6th months were lower than that in the 1st month postoperatively, but there was no statistical difference between the TEQ scores in the 3rd and 6th months postoperatively. It was observed that the improvement in postoperative tinnitus stabilized gradually. There was no significant difference between the preoperative and postoperative hearing test results.

Venous pulsatile tinnitus can be diagnosed by careful medical history taking, physical examination, and imaging. Surgery under local anesthesia is convenient for the surgeon to observe real-time improvement in tinnitus, which aids in accurate evaluation of the shape of the sigmoid sinus and reducing the incidence of complications. Therefore, its clinical application is recommended.