Sigmoid　sinus　wall　anomalies　(SSWA)　are　a　common　pathophysiology　of　pulsatile　tinnitus　(PT)　and　usually　treated　by　sigmoid　sinus　wall　dehiscence　(SSWD)　resurfacing　surgery.　However,　symptoms　of　tinnitus　remain　unrelieved　after　surgery　in　some　patients　with　PT,　and　even　new　tinnitus　appears.　The　cause　of　the　difference　in　therapeutic　effects　is　unclear.　In　this　study,　eight　patient-specific　SSWA　geometric　models　were　reconstructed　on　the　basis　of　computed　tomography　angiography,　including　four　cases　of　postoperative　rehabilitation　(group　1,　1-4　cases)　and　four　cases　of　non-rehabilitation　(group　2,　5-8　cases).　Transient-state　computational　fluid　dynamics　(CFD)　was　performed　to　clarify　the　SS　blood　flow　pattern　and　hemodynamic　states.　The　wall　pressure　distribution　on　SSWA　area,　pressure　difference,　and　flow　pattern　in　SS　were　calculated　to　evaluate　the　hemodynamic　changes　of　rehabilitation　and　non-rehabilitation　patients　before　and　after　surgery.　The　difference　of　hemodynamics　between　these　patients　was　statistically　analyzed.　The　accuracy　of　CFD　simulation　was　evaluated　by　cross　validating　the　numerical　and　particle　image　velocimetry　experimental　results.　Results　showed　that　the　SSWA　area　in　patients　with　PT　was　loaded　with　high　pressure.　No　difference　was　found　in　the　hemodynamic　characteristics　between　the　two　groups　pre-　and　postoperation.　When　the　average　pressure　(P-avg)　and　time-average　P-avg　(TAP(avg))　on　the　SSWA　area　were　studied,　the　TAP(avg)　difference　pre-　and　postoperation　between　the　two　groups　was　found　significant　(p　=　0.0021).　The　TAP(avg)　difference　had　a　negative　change　in　postoperative　rehabilitation　patients　(case　1,　-44.49　Pa　vs.　case　2,　-15.85　Pa　vs.　case　3,　-25.88　Pa　vs.　case　4,　-16.58　Pa).　The　postoperative　TAP(avg)　of　non-rehabilitation　patients　was　higher　than　the　preoperative　one　(case　5,　24.70　Pa　vs.　case　6,　28.56　Pa　vs.　case　7,　5.81　Pa　vs.　case　8,　13.04　Pa).　The　velocity　streamlines　in　the　SS　with　rehabilitation　became　smoother　and　more　regular　than　that　without　rehabilitation.　By　contrast,　the　velocity　streamlines　in　SS　without　rehabilitation　showed　increased　twisting　and　curling.　No　difference　was　found　in　time-average　volume-averaged　vorticity　(TAV　avgV)　between　the　two　groups.　Therefore,　the　high　pressure　of　the　vessel　wall　on　SSWA　area　was　one　of　the　causes　of　PT.　The　variation　of　SSWA　wall　pressure　difference　before　and　after　PT　was　the　cause　of　the　difference　in　therapeutic　effects　after　SSWD　resurfacing　surgery.　In　patients　with　SSWA,　disordered　blood　flow　in　SS　was　another　cause　of　PT.　SSWD　repair　may　relieve　tinnitus　to　some　extent,　but　blood　flow　disorders　may　still　arise.　(c)　2020　Elsevier　B.V.　All　rights　reserved.