목적: Sigmoid sinus diverticulum/dehiscence (SSD) is known to be one of the treatable causes of venous pulsatile tinnitus. It can be diagnosed with temporal bone computed tomography(CT) or magnetic resonance angiogram/venogram(MRA). If patients' symptoms are intolerable, usually surgical treatment is preferred. We describe new surgical technique using sigmoid sinus re-roofing procedure and analyzed it’s feasibility. 방법:From January 2020 to July 2023, approximately 150 patients with pulsatile tinnitus were evaluated at 2 different tertiary hospitals. Of these, 12 patients were diagnosed with a sigmoid sinus diverticulum/deheiscence, and 7 of these patients underwent surgical treatment. Five patients were treated by tailored reroofing (TRR) technique of sigmoid sinus and two patients were treated as transmastoid resurfacing (MRS) technique of sigmoid sinus. We compared Korean tinnitus handicap inventory(K-THI) score, pure tone audiogram(PTA) threshold, CT scan before and one month after surgeries. Operation time was also analyzed. 결과:In TRR cases, K-THI score of were reduced from preoperatively 55.0±31.4 to 4.0±3.0 and SSD were well repositioned and covered by bone chip postoperatively. Whereas, in MRS cases, K-THI score reduced from 41.0±9.9 preoperatively to 15.0±21.2 well covered by bone cement postoperatively. Ipsilateral PTA threshold(6-frequency average) of TRR were 6.5±2.0 dB preoperatively and 8.0±3.0dB postoperatively. Average surgical time of five TRR cases and two MRS were 77.5±24.0minutes and 174.0±75.0minutes respectively. There were no complications. 결론:Despite lack of sufficient cases, TRR takes a reasonable amount of time, affords a smaller incision, and seems to provide good outcomes for patients compare to conventional MRS for pulsatile tinnitus patients who have sigmoid sinus diverticulum/dehiscence.