CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus

Xu, Shuaishuai; Ruan, Shidong; Liu, Shanfeng; Xu, Jianrong; Gong, Ruozhen

doi:10.1007/s00234-018-1987-3

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…A previous study showed that most cases of SSD occur on the right side in female patients. 1 , 2 , 3 , 4 , 5 , 6 Our observations are consistent with previous studies. SSD formation has been suggested to be attributable to right-sided venous dominance.…”

Section: Discussionsupporting

confidence: 93%

“…Previous studies have suggested that SAS is mainly due to compression of the ICA by the SP; in this type, the SP is not necessarily elongated, but it can also be due to lateral or medial deviation. 3 , 22 In this study, although only two patients occasionally experienced symptoms of head and neck pain and the feeling of a foreign body in the throat, the left IJV was compressed by the SP in eight patients. The length of the SP was normal in eight patients, with only one patient showing elongation of the SP; however, the left medial angulation was larger than on the right side.…”

Section: Discussionmentioning

confidence: 54%

“… 1 , 2 Sigmoid sinus diverticulum (SSD) has been considered the most common cause of PT. 3 , 4 , 5 However, there is ongoing debate regarding the origin of SSD. As most patients develop PT in late middle age, and therefore congenital SSD seems unlikely, SSD may be caused by flow forcefully hitting the sinus wall and thus leading to flow-induced outward remodeling and diverticulum formation.…”

Section: Introductionmentioning

confidence: 99%

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The styloid process and the formation of sigmoid sinus diverticulum: is there a link?

Lou

2021

Brazilian Journal of Otorhinolaryngology

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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The styloid process and the formation of sigmoid sinus diverticulum: is there a link?

Lou

2021

Brazilian Journal of Otorhinolaryngology

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“…Previous researchers have also suggested a close relationship between idiopathic intracranial hypertension (IIH) and SS-Div/SS-Deh in patients with PT 24,25 . Also, PT arising from SS-Div/SS-Deh is common in women with relatively high BMI.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of surgical outcome in subjects with pulsatile tinnitus originating from the sigmoid sinus

Lee

Kim

Bae

et al. 2020

Sci Rep

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A dominant sigmoid sinus with either diverticulum or dehiscence (SS-Div/SS-Deh) is a common cause of pulsatile tinnitus (PT). For PT originating from SS-Div/SS-Deh, an etiology-specific and secure reconstruction using firm materials is vital for optimal outcomes. As a follow-up to our previous reports on transmastoid SS resurfacing or reshaping for SS-Div/SS-Deh, this study aimed to evaluate the long-term results of transmastoid resurfacing/reshaping. We retrospectively reviewed 20 PT patients who were diagnosed with SS-Div/SS-Deh, underwent transmastoid resurfacing/reshaping, and were followed up for more than 1 year postoperatively. For PT, immediate and long-term changes (> 1 year) in loudness and annoyance were analyzed using the visual analog scale (VAS). Additionally, pre and postoperative objective measurements of PT using transcanal sound recording and spectro-temporal analysis (TSR-STA), imaging results, and audiological findings were comprehensively analyzed. Significant improvements in PT were sustained or enhanced for > 1 year (median follow-up period: 37 months, range: 12–54 months). On TSR-STA, both peak and root mean square amplitudes decreased after surgery. Also, the average pure-tone threshold at 250 Hz improved after surgery. Thus, our long-term follow-up data confirmed that the surgical management of PT originating from SS-Div/SS-Deh is successful with regard to both objective and subjective measures.

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“…Width difference of more than 50% or 75% was usually used [5,8]. A combined conduit score described by Farb et al [18] and a new index described by Carvalho GB et al [19] have also been adopted [6,20]. Those methods may partially obscure the effect of TSS in PT and sometimes make it difficult to compare the results.…”

Section: Discussionmentioning

confidence: 99%

CT venography correlate of transverse sinus stenosis and venous transstenotic pressure gradient in unilateral pulsatile tinnitus patients with sigmoid sinus wall anomalies

Zhao

Ding

et al. 2020

Eur Radiol

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Objectives To investigate the correlation between transverse sinus stenosis (TSS) and transstenotic pressure gradient (TPG) in unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA). Methods Fifty-seven patients with unilateral venous PT were retrospectively included. All of them underwent CT venography and catheter manometry, accompanied with SSWA. The degree, length, shape (intrinsic/extrinsic/dysplasia), location (proximal/middle/distal, referring to the relative position of TSS and the Labbé vein junction) of TSS, the types of SSWA (dehiscence/diverticulum), and the degree of transverse sinus outflow laterality were assessed, and the correlations with ipsilesional TPG were analyzed. Results The mean value of ipsilesional TPG was 7.61 ± 0.52 mmHg. The degree and length of ipsilesional TSS were positively correlated with TPG (p < 0.001, p’ < 0.001), respectively. TPG was significantly larger in patients with contralateral transverse sinus dysplasia than those without (p = 0.023) and significantly smaller in patients with ipsilesional sigmoid sinus diverticulum than those with isolated dehiscence (p = 0.001). No statistical difference in TPG was shown between ipsilesional TSSs of different shapes or locations (p > 0.05). No correlation was noted between the degree of ipsilesional transverse sinus outflow laterality and TPG (p = 0.051). Stepwise linear regression indicated that the degree (β = 9.207, 95% CI = 3.558–14.856), length (β = 0.122, 95% CI = 0.025–0.220) of ipsilesional TSS, and contralateral transverse sinus dysplasia (β = 1.875, 95% CI = 0.220–3.530) were significantly correlated with TPG (R2 = 0.471). Conclusions The degree, length of ipsilesional TSS, and contralateral transverse sinus dysplasia may be used to predict TPG in unilateral PT patients with SSWA. Key Points • CT venography may act as a screening tool to help low-probability unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA) avoid invasive catheter manometry. • The degree and length of ipsilesional transverse sinus stenosis (TSS) are positively correlated with transtenotic pressure gradient (TPG) in unilateral PT patients with SSWA. • Ipsilesional TPG is larger in unilateral PT patients with contralateral transverse sinus dysplasia than those without and is smaller in unilateral PT patients with sigmoid sinus diverticulum than those with isolated dehiscence.

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CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus

Abstract: In PT patients, SSD has a significant correlation with PT and a potential correlation with IIH.

Cited by 11 publications

References 22 publications

The styloid process and the formation of sigmoid sinus diverticulum: is there a link?

The styloid process and the formation of sigmoid sinus diverticulum: is there a link?

Longitudinal analysis of surgical outcome in subjects with pulsatile tinnitus originating from the sigmoid sinus

CT venography correlate of transverse sinus stenosis and venous transstenotic pressure gradient in unilateral pulsatile tinnitus patients with sigmoid sinus wall anomalies

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