scholarly journals Temporal Bone Pneumatization and Pulsatile Tinnitus Caused by Sigmoid Sinus Diverticulum and/or Dehiscence

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Liu Wenjuan ◽  
Liu Zhaohui ◽  
Zheng Ning ◽  
Zhao Pengfei ◽  
Dong Cheng ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Sigmoid Sinus ◽  
Healthy People ◽  
Pulsatile Tinnitus ◽  
Contrast Enhanced Ct ◽  
Significant Difference ◽  
Temporal Bone Pneumatization ◽  
Grade Ii ◽  
Air Cells ◽  
Grade Iii

Background. Although air cells within temporal bone may play an important role in the transmission of pulsatile tinnitus (PT) noise, it has not been studied systematically.Purpose. To evaluate the difference in temporal bone pneumatization between PT patients with sigmoid sinus diverticulum and/or dehiscence (SSDD) and healthy people.Material and Methods. A total of 199 unilateral persistent PT patients with SSDD and 302 control subjects underwent dual-phase contrast-enhanced CT (DP-CECT), to assess the grade of temporal bone pneumatization in each ear.Results. In the bilateral temporal bone of 302 controls, 16 ears were grade I, 53 were grade II, 141 were grade III, and 394 were grade IV. Among the affected ears of 199 PT cases, 1 ear was grade I, 18 were grade II, 53 were grade III, and 127 were grade IV. There was no significant difference in the pneumatization grade between the affected PT ear and either ear in the healthy subjects(p>0.05).  Conclusion. Although air cells within the temporal bone are an important factor in the occurrence of PT, its severity does not differ significantly from the pneumatization of healthy people.

scholarly journals Temporal bone contrast-enhanced high-resolution CT evaluation of pulsatile tinnitus after sigmoid sinus wall reconstruction

2018 ◽  
Vol 60 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Heyu Ding ◽  
Pengfei Zhao ◽  
Han Lv ◽  
Xuehuan Liu ◽  
Rong Zeng ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Short Interval ◽  
Sigmoid Sinus ◽  
Imaging Features ◽  
Pulsatile Tinnitus ◽  
Interval Group ◽  
Sinus Wall ◽  
Contrast Enhanced ◽  
Air Cells ◽  
Mastoid Air Cells

Background Sigmoid sinus wall reconstruction (SSWR) is a proven effective treatment for pulsatile tinnitus (PT) caused by sigmoid sinus wall dehiscence (SSWD) with or without sigmoid sinus diverticulum (SSD); however, comprehensive analysis of the postoperative imaging manifestations has not yet been reported. Purpose To analyze temporal bone computed tomography (CT) imaging features following SSWR in patients with PT. Material and Methods Following SSWR, temporal bone contrast-enhanced high-resolution CT (HRCT) images from 33 PT cases were retrospectively analyzed. Patients were divided into two groups based on follow-up interval: a short-interval group (≤18 months, 12 cases) and a long-interval group (>18 months, 21 cases). The mending material density and morphology was analyzed. Postoperative changes of the venous sinus were evaluated. Imaging manifestations of the normal temporal bone and mastoid air cells adjacent to the operative field were observed. Results The order of CT values of mending materials was significantly lower in the short-interval group than in the long-interval group (Z = −4.716, P < 0.001); the incidence of complete newly remodeled cortical bone on the rim of the mending materials was significantly higher in the long-interval group than in the short-interval group ( P < 0.001). Eleven patients (33.3%) showed varying degrees of remnant SSWD. The mending materials and normal mastoid bone structure showed complete fusion (n = 12, 36.4%), partial fusion (n = 16, 48.5%), or complete separation (n = 5, 15.2%). Conclusion Temporal bone contrast-enhanced HRCT can be used to observe imaging features of the mending materials, venous sinus, adjacent normal temporal bone and mastoid air cells following SSWR.

Correlation between temporal bone pneumatization, location of lateral sinus and length of the mastoid process

1992 ◽  
Vol 106 (6) ◽  
pp. 485-489 ◽  
Author(s):  
S. Turgut ◽  
M. Tos
Keyword(s):  
Temporal Bone ◽  
Middle Ear ◽  
External Auditory Canal ◽  
Sigmoid Sinus ◽  
Mastoid Process ◽  
Lateral Sinus ◽  
Gross Pathology ◽  
Significant Difference ◽  
Temporal Bone Pneumatization ◽  
Temporal Bones

AbstractThe relationship between temporal bone pneumatization and the location of the lateral sinus and length of the mastoid process was investigated in 60 fresh frozen adult temporal bones, by plain X-rays, computed tomography and surgical dissection including otomicroscopic findings. Temporal bone pneumatization was classified as small, moderate and large. After drilling, the shortest distances between the middle fossa dura and mastoid tip representing the mastoid length and between the sigmoid sinus and posterior border of external auditory canal were measured and compared to the degree of pneumatization. The distances in the specimens with pathological eardrum and adhesions in the middle ear were compared to the ones without gross pathology. The length of mastoid process was significantly shorter in specimens with small pneumatization than those with large (Mann Whitney P<0.001).The specimens with a pathological eardrum and middle ear adhesions had a significantly shorter mastoid length than those without gross pathology. There was no significant difference between degree of pneumatization and the shortest distance between sigmoid sinus and external auditory canal (Mann Whitney P>0.05). It is demonstrated that the ‘under-developed’ mastoid process can be a consequence of hampered pneumatization.

scholarly journals Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 734
Author(s):  
Ivona Djordjevic ◽  
Dragoljub Zivanovic ◽  
Ivana Budic ◽  
Ana Kostic ◽  
Danijela Djeric
Keyword(s):  
Splenic Abscess ◽  
Operative Management ◽  
High Energy ◽  
Significant Difference ◽  
Injury Grade ◽  
Grade Ii ◽  
The Mean ◽  
Non Operative Management ◽  
Grade Iii

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

Effects of Radiofrequency Energy on Human Articular Cartilage

2005 ◽  
Vol 33 (7) ◽  
pp. 1035-1039 ◽  
Author(s):  
Sean Caffey ◽  
Edward McPherson ◽  
Brian Moore ◽  
Thomas Hedman ◽  
C. Thomas Vangsness
Keyword(s):  
Cell Death ◽  
Articular Cartilage ◽  
Dead Cell ◽  
Radiofrequency Energy ◽  
Human Articular Cartilage ◽  
Human Cartilage ◽  
Cellular Death ◽  
Significant Difference ◽  
Grade Ii ◽  
Grade Iii

Background Previous radiofrequency work has not rigidly controlled energy application to the articular cartilage, giving uncertain results published to date. Hypothesis At minimal settings, radiofrequency probes cause cell death in measurable areas when applied to human articular cartilage. Study Design Controlled laboratory study. Methods Simulating operating room conditions, 5 commercially available radiofrequency probes were attached to a customized jig to standardize a minimal contact pressure of each probe tip to 2.0 g. Keeping all variables the same, probes were placed on specific points of fresh grade II human cartilage with treatment times of 1 and 3 seconds at the manufacturer's recommended settings. Grade III cartilage was also tested with a treatment time of 3 seconds, and grade II cartilage was studied with the probe held 1 mm off the cartilage surface. Cartilage was blindly analyzed by confocal microscopy using a live/dead cell viability assay to determine the extent of cell death. Results Radiofrequency probes produced significant cellular death in the form of a half-circle into the cartilage to variable depths. For treatment times of 1 and 3 seconds, cell death measurements ranged from 404 to 539 μm and 1034 to 1283 μm, respectively. One probe failed to show any effect, with minimal evidence of cell death or cartilage smoothing. When probes were kept a 1.0-mm distance above the cartilage, no cell death or cartilage smoothing was noted. Radiofrequency treatment of grade III cartilage penetrated to the subchondral bone. There was no statistically significant difference between the damage caused by monopolar and bipolar probes when tested under these rigidly controlled conditions. Conclusion These results showed significant cellular death at these minimal conditions to the underlying chondrocytes with radiofrequency probes. Surgeons using this technology need to be aware of the power and dangerous potential these probes can have on articular cartilage.

Oncologic benefits of dural resection in spinal meningiomas: a meta-analysis of Simpson grades and recurrence rates

2020 ◽  
Vol 32 (3) ◽  
pp. 441-451 ◽  
Author(s):  
Sean M. Barber ◽  
Sanjay Konakondla ◽  
Jonathan Nakhla ◽  
Jared S. Fridley ◽  
Jimmy Xia ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Statistical Significance ◽  
Neurological Deficits ◽  
Recurrence Rates ◽  
Systematic Analysis ◽  
Simpson Grade ◽  
Significant Difference ◽  
Grade Ii ◽  
Spinal Meningiomas ◽  
Grade Iii

OBJECTIVEWhile resection of the dural attachment has been shown by Simpson and others to reduce recurrence rates for intracranial meningiomas, the oncological benefit of dural resection for spinal meningiomas is less clear. The authors performed a systematic analysis of the literature, comparing recurrence rates for patients undergoing various Simpson grade resections of spinal meningiomas to better understand the role of dural resection on outcomes after resection of spinal meningiomas.METHODSThe PubMed/Medline database was systematically searched to identify studies describing oncological and clinical outcomes after Simpson grade I, II, III, or IV resections of spinal meningiomas.RESULTSThirty-two studies describing the outcomes of 896 patients were included in the analysis. Simpson grade I, grade II, and grade III/IV resections were performed in 27.5%, 64.6%, and 7.9% of cases, respectively. The risk of procedure-related complications (OR 4.75, 95% CI 1.27–17.8, p = 0.021) and new, unexpected postoperative neurological deficits (OR ∞, 95% CI NaN–∞, p = 0.009) were both significantly greater for patients undergoing Simpson grade I resections when compared with those undergoing Simpson grade II resections. Tumor recurrence was seen in 2.8%, 4.1%, and 39.4% of patients undergoing Simpson grade I, grade II, and grade III/IV resections over a mean radiographic follow-up period of 99.3 ± 46.4 months, 95.4 ± 57.1 months, and 82.4 ± 49.3 months, respectively. No significant difference was detected between the recurrence rates for Simpson grade I versus Simpson grade II resections (OR 1.43, 95% CI 0.61–3.39, p = 0.43). A meta-analysis of 7 studies directly comparing recurrence rates for Simpson grade I and II resections demonstrated a trend toward a decreased likelihood of recurrence after Simpson grade I resection when compared with Simpson grade II resection, although this trend did not reach statistical significance (OR 0.56, 95% CI 0.23–1.36, p = 0.20).CONCLUSIONSThe results of this analysis suggest with a low level of confidence that the rates of complications and new, unexpected neurological deficits after Simpson grade I resection of spinal meningiomas are greater than those seen with Simpson grade II resections, and that the recurrence rates for Simpson grade I and grade II resections are equivalent, although additional, long-term studies are needed before reliable conclusions may be drawn.

A study on relationship between pulsatile tinnitus and temporal bone pneumatization grade

2019 ◽  
Vol 22 (7) ◽  
pp. 788-796 ◽  
Author(s):  
Shan Tian ◽  
Xingyu Fan ◽  
Yawei Wang ◽  
Zhaohui Liu ◽  
Lizhen Wang
Keyword(s):  
Temporal Bone ◽  
Pulsatile Tinnitus ◽  
Temporal Bone Pneumatization

Pulsatile tinnitus as a rare presenting symptom of residual cholesteatoma

2004 ◽  
Vol 118 (2) ◽  
pp. 165-166 ◽  
Author(s):  
M. Falcioni ◽  
A. Taibah ◽  
Rohit
Keyword(s):  
Intracranial Hypertension ◽  
Temporal Bone ◽  
Sigmoid Sinus ◽  
Benign Intracranial Hypertension ◽  
Pulsatile Tinnitus ◽  
Arteriovenous Fistulae ◽  
Life Threatening

Pulsatile tinnitus is an uncommon otological symptom, which often presents a diagnostic and management dilemma to the otolaryngologist. This symptom always deserves a thorough evaluation to avoid disastrous consequences from potentially life-threatening associated pathology. In most of the patients a treatable underlying aetiology can be identified. Frequentcauses mentioned in the literature responsible for pulsatile tinnitus are benign intracranial hypertension syndrome, temporal bone paragangliomas and arteriovenous fistulae. Pulsatile tinnitus as a consequence of sigmoid sinus compression by a cholesteatoma has not been reported previously in the literature. Here a case of residual cholesteatoma with pulsatile tinnitus is presented, nine years after the first surgery.

Classification of temporal bone pneumatization based on sigmoid sinus using computed tomography

2007 ◽  
Vol 62 (11) ◽  
pp. 1110-1118 ◽  
Author(s):  
S.-J. Han ◽  
M.H. Song ◽  
J. Kim ◽  
W.-S. Lee ◽  
H.-K. Lee
Keyword(s):  
Computed Tomography ◽  
Temporal Bone ◽  
Sigmoid Sinus ◽  
Temporal Bone Pneumatization
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