CT evaluation of unilateral pulsatile tinnitus with jugular bulb wall dehiscence

Dai, Chihang; Zhao, Peng; Ding, Heyu; Lv, Han; Qiu, Xiaoyu; Li, Xiaoshuai; Xu, Ning; Meng, Xuxu; Wang, Guo‐Peng; Xie, Jing; Yang, Zhenghan; Gong, Shusheng; Wang, Zhenchang

doi:10.1007/s00330-022-09352-8

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…This study also found that the SSWD group had a smaller area at the proximal end of the TS, which narrowed and accelerated the blood flow. This finding was consistent with most previous reports ( 14 , 15 , 19 ). The JBWD group had less narrowing at the proximal end of the TS than the SSWD group, resulting in less velocity increase.…”

Section: Discussionsupporting

confidence: 94%

“…Transverse sinus (TS) stenosis causes higher blood velocity and flow rate, which is critical to bone abnormalities in PT associated with SSWD ( 15 , 18 ). A recent paper presented differences in CT findings between PT patients with JBWD and SSWD, suggesting that the upstream vascular morphology of the jugular bulb (JB) differs between the two groups ( 19 ). However, the hemodynamic characteristics of PT with JBWD and the differences between the JBWD and SSWD groups remain poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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Hemodynamic assessments of unilateral pulsatile tinnitus with jugular bulb wall dehiscence using 4D flow magnetic resonance imaging

Dai,

Zhao,

Wang

et al. 2024

Quant Imaging Med Surg

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Background Pulsatile tinnitus (PT) is a type of tinnitus characterized by a rhythmic sound that is synchronous with the heartbeat. One of the possible causes of PT is the jugular bulb wall dehiscence (JBWD). However, the hemodynamics of this condition are not well understood. To elucidate this issue, the present study aimed to compare the blood flow of PT patients with JBWD, PT patients with sigmoid sinus wall dehiscence (SSWD), and volunteers. Methods A retrospective case-control study was conducted, which enrolled patients with unilateral PT who had undergone both computed tomography angiography (CTA) and four-dimensional (4D) flow magnetic resonance imaging (MRI) examinations at the Department of Otolaryngology-Head and Neck Surgery of Beijing Friendship Hospital affiliated to Capital Medical University between January 2019 and July 2023. After excluding the possible causes of PT, the patients were divided into the JBWD group and SSWD group according to the presence or absence of JBWD and/or SSWD. Finally, 11 female unilateral PT patients with JBWD (JBWD group, 11sides), 22 age- and side-matched female patients with SSWD (SSWD group, 22 sides), and 22 age-matched female volunteers (volunteer group, 36 sides) were enrolled. The area, maximum voxel velocity (V v-max ), maximum velocity (V max ), average velocity (V avg ), and average blood flow rate (Q) were measured in the transverse sinuses (TSs), sigmoid sinuses (SSs), and jugular bulb (JB). The vortex flow pattern was also assessed. Fisher’s exact test and Bonferroni correction were used for count data, with P<0.017 was considered statistically significant. Shapiro-Wilk test, one-way analysis of variance (ANOVA), Kruskal-Wallis H test, paired-samples t -test, and Wilcoxon matched-pairs signed-rank test were used for continuous variables depending on the distribution and variance of the data. The P<0.05 and corrected P<0.05 was considered statistically significant. Results The area and Q of TSs and JB on the symptomatic side were higher than those on the contralateral side in the JBWD group (TSs: P area =0.004, P flow =0.002; JB: P area =0.034, P flow =0.018). The area was larger and velocities were lower in the JBWD group at the TSs than the SSWD group (P area =0.004, P Vv-max =0.009, P Vmax =0.021, P Vavg =0.026), and velocities were higher at the distal TSs and SSs than the volunteer group (TSs: P Vv-max =0.042, P Vmax =0.046, P Vavg =0.040; SSs: P Vv-max =0.007, P Vmax =0.001, P Vavg ...

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Hemodynamic assessments of unilateral pulsatile tinnitus with jugular bulb wall dehiscence using 4D flow magnetic resonance imaging

Dai,

Zhao,

Wang

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

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“…This leads to abnormal discharge of the hair cells and irreversible damage to cochlear function, resulting in symptoms such as tinnitus and hearing loss. On the one hand, the eddy currents formed by the high JB can damage the vessel walls of the JB and on the other hand, the venous outflow laterality may generate a force that acts on the high JB, making it susceptible to mural fracture ( 13 ). In this way, the sound and shock produced by the blood vortex are transmitted through the JBWD into the inner ear or mastoid cavity.…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous sinus stenting and jugular bulb embolization for pulsatile tinnitus: A case report

Xu,

Dong,

Zheng

et al. 2024

Front. Neurol.

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BackgroundPulsatile tinnitus (PT) is a rare form of tinnitus that aligns with the heartbeat. It is typically brought on by lesions with significant vascularity, which produce aberrant sound conduction and increase the risk of mental health issues and hearing loss. Venous PT is more prevalent than arterial PT. Open procedures or interventional procedures can be used to treat PT. We present here a case of PT caused by venous luminal stenosis combined with jugular bulb (JB) malformation, which was improved by stenting and JB embolization.Case presentationA 59-year-old woman presented with long-term tinnitus consistent with heart rhythm and hearing loss, accompanied by anxiety, insomnia, and depression. The results of brain MRV, CT, and DSA showed stenosis of the right sigmoid sinus and high jugular bulb (JB) with dehiscence of the JB wall. The patient saw a significant improvement in PT symptoms following sigmoid sinus stenting and spring coil embolization of the high JB, following the diagnosis of PT. The patient had no PT recurrence for the course of the 31-month follow-up period.ConclusionIn the present PT case, there was a simultaneous onset of the right sigmoid sinus stenosis and the high JB with the JB wall abnormalities. Sigmoid sinus stenting and spring coil embolization of high JB may be a treatment for the PT, but the prevention of post-stenting complications is still an issue that requires great attention and needs further study.

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Cerebral Sinus Hemodynamics in Adults Revealed by 4D Flow MRI

Dai,

Zhao,

Ding

et al. 2024

Magnetic Resonance Imaging

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BackgroundThe hemodynamics of the cerebral sinuses play a vital role in understanding blood flow‐related diseases, yet the hemodynamics of the cerebral sinuses in normal adults remains an unresolved issue.PurposeTo evaluate hemodynamics in the cerebral sinus of adults using 4‐dimensional flow MRI (4D Flow MRI).Study TypeCross‐sectional.PopulationNinety‐nine healthy volunteers (mean age, 42.88 ± 13.16 years old; females/males, 55/44).Field Strength/Sequence3 T/4D Flow MRI.AssessmentThe blood flow velocity, average blood flow rate (Q), and vortexes at the superior sagittal sinus (SSS), straight sinus (STS), transverse sinus, sigmoid sinus, and jugular bulb of each volunteer were evaluated by two independent neuroradiologists. The relationship between the total cerebral Q and sex and age was also assessed. Twelve volunteers underwent two scans within a month.Statistical TestsThe intraclass correlation coefficient (ICC) evaluated the inter‐observer agreement. Blood flow parameters among volunteers were compared by the independent‐sample t‐test or Mann–Whitney U test. The multiple linear regression equation was used to evaluate the relationship between total cerebral Q and age and sex. P < 0.05 indicated statistical significance.ResultsThe test–retest and interobserver reliability of average velocity and Q were moderate to high (ICC: 0.54–0.99). Cerebral sinus velocity varied by segment and cardiac cycle. The SSS's velocity and Q increased downstream and Q near torcular herophili was 3.5 times that through the STS. The total cerebral Q decreased by 0.06 mL/s per year (β = −0.06 ± 0.013) and was sex‐independent within the group. Vortexes were found in 12.12%, 8.9%, and 59.8% of torcular herophili, transverse‐sigmoid junction, and jugular bulb, respectively, and were related to higher upstream flow.Data ConclusionCerebral sinuses could be measured visually and quantitatively in vivo by 4D Flow MRI, providing a basis for future research on pulsating tinnitus, multiple sclerosis, and other related diseases.Evidence Level2Technical EfficacyStage 1

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CT evaluation of unilateral pulsatile tinnitus with jugular bulb wall dehiscence

Cited by 4 publications

References 39 publications

Hemodynamic assessments of unilateral pulsatile tinnitus with jugular bulb wall dehiscence using 4D flow magnetic resonance imaging

Hemodynamic assessments of unilateral pulsatile tinnitus with jugular bulb wall dehiscence using 4D flow magnetic resonance imaging

Cerebral venous sinus stenting and jugular bulb embolization for pulsatile tinnitus: A case report

Cerebral Sinus Hemodynamics in Adults Revealed by 4D Flow MRI

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