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

Abstract

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.

Intraoperative Investigation of Vibration and Acoustic Characteristics of Venous Pulsatile Tinnitus Using Confocal Laser Displacement Sensor, Doppler Ultrasonography, and Piezoelectric Film Sensor: A Pilot Study

“…This inference is highly plausible since the blood flow sound sampled by the ultrasonographic transducer closely matched the subjective perception of PT in all of our subjects, and the generated fluid sound most likely originates from the vortices at the transverse-sigmoid junction observed by intraoperative Doppler according to our previous report. (8) In line with a recent case-series study using a trans-canal recording technique, the frequency at the peak PT amplitude in our subjects was near 250 Hz, (23) and the harmony of the frequency range extended up to 1000-1500 Hz. More importantly, the detected displacement frequency of the bone and vascular structures was primarily below 20 Hz, which implies that the sigmoid plate most likely fails to preclude the sound transmission of the pathological aggregation of the sinus blood flow rather than being a source of sound production per se.…”

Hydroacoustic Sonification and Flow Pattern Investigation of Venous Pulsatile Tinnitus Using MEMS Hydrophone Sensing and Dye Flow Visualization Techniques: Pilot 3D Printing, Computational Fluid Dynamics, and Psychoacoustic Study

“…The frequency bandwidth of PT is generally below 1.5 kHz, occasionally extending up to 1.5-2 kHz. (3,17) This, in turn, can be verified by psychoacoustic testing, during which patients generally indicate high resemblance of their PT sound to the given 1/3 octave narrow-band noises with center frequency of 125/250/500/750 Hz. Song et al first analyzed patient PT of different vascular origins captured by the trans-external auditory canal recording technique using spectrotemporal analysis.…”

Cortical Oscillatory Signatures Reveal the Prerequisites for Tinnitus Perception: A Comparison of Subjects With Sudden Sensorineural Hearing Loss With and Without Tinnitus

“…The hearing thresholds for seven different octave frequencies (0.25, 0.5, 1, 2, 3, 4, and 8 kHz) were evaluated using pure-tone audiometry in a soundproof booth. The mean hearing threshold was calculated using the average of the hearing thresholds at 0.5, 1, 2, and 4 kHz (Han et al, 2019;Shim et al, 2019;Bae et al, 2020;Huh et al, 2020;Lee et al, 2020b;Song et al, 2020). At each subject's initial visit, we obtained a structured history of the characteristics of tinnitus including its presence, laterality, and psychoacoustic nature (pure-tone or narrow-band noise).…”