scholarly journals Postoperative Imaging Findings following Sigmoid Sinus Wall Reconstruction for Pulse Synchronous Tinnitus

2015 ◽  
Vol 37 (1) ◽  
pp. 136-142 ◽  
Author(s):  
P. Raghavan ◽  
Y. Serulle ◽  
D. Gandhi ◽  
R. Morales ◽  
K. Quinn ◽  
...  
Keyword(s):  
Sigmoid Sinus ◽  
Imaging Findings ◽  
Postoperative Imaging ◽  
Sinus Wall

Transmastoid Hydroxyapatite Resurfacing for Sigmoid Sinus Wall Anomalies Causing Pulsatile Tinnitus

2021 ◽  
pp. 000348942098740
Author(s):  
Ian Newberry ◽  
Julie Highland ◽  
Alvin DeTorres ◽  
Richard Gurgel
Keyword(s):  
Case Series ◽  
Sigmoid Sinus ◽  
Pulsatile Tinnitus ◽  
Retrospective Case ◽  
Tertiary Referral Center ◽  
Operative Outcomes ◽  
Sinus Wall ◽  
Objective Tinnitus ◽  
Materials Used

Objective: Comprising 4% of tinnitus, pulsatile tinnitus (PT) can be particularly difficult for affected patients as well as surgeons looking to address their symptoms. Often the cause is not identified but can be secondary to turbulent flow in or near the sigmoid sinus, particularly if there is an identifiable sigmoid sinus dehiscence (SSDe) and/or diverticulum (SSDi). These sigmoid sinus wall anomalies (SSWA) may be treated with transmastoid sigmoid sinus resurfacing; however, this intervention remains relatively novel and its technique, materials used, resolution success, and complications need to be continuously reviewed. Methods: A retrospective case series of patients with PT due to SSWA at a tertiary referral center was reviewed. A total of 6 patients (7 ears) treated by transmastoid resurfacing using hydroxyapatite (HA) were retrospectively assessed. Pre-operative demographics and symptoms, pre- and post-operative hearing results, and post-operative outcomes were reviewed. Results: All patients were female with an average BMI of 32.9 (±5.4) and a mean age of 45.5 years (±15.3). Mean follow-up was 648 days. Objective tinnitus was noted in all ears with SSDi (100%); however, no objective tinnitus was noted with purely SSDe. In 100% of ears, PT was diminished with ipsilateral jugular compression and was amplified with contralateral head turn. Pre-operative symptoms of PT resolved in all patients, but delayed recurrence (>1 year) occurred in 1 ear (14%). No patient had pre- or post-operative hearing loss. No major complications were encountered. Conclusions: Transmastoid resurfacing for SSWA with HA bone cement is a safe, reliable intervention in properly identified PT patients.

In Response to Letter to the Editor Regarding: Evaluation and Treatment of Pulsatile Tinnitus Associated With Sigmoid Sinus Wall Anomalies

2019 ◽  
Vol 129 (4) ◽  
pp. E128-E128 ◽  
Author(s):  
David J. Eisenman ◽  
Ronna Hertzano ◽  
Prashant Raghavan ◽  
Robert Morales
Keyword(s):  
Sigmoid Sinus ◽  
Pulsatile Tinnitus ◽  
Letter To The Editor ◽  
Sinus Wall

Pattern and severity of transverse sinus stenosis in patients with pulsatile tinnitus associated with sigmoid sinus wall anomalies

2020 ◽  
Vol 130 (4) ◽  
pp. 1028-1033 ◽  
Author(s):  
Daniel Hewes ◽  
Robert Morales ◽  
Prashant Raghavan ◽  
David J. Eisenman
Keyword(s):  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Pulsatile Tinnitus ◽  
Sinus Wall ◽  
Sinus Stenosis

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.

Intracranial hypertension secondary to sigmoid sinus compression by group A streptococcal epidural abscess

2009 ◽  
Vol 124 (1) ◽  
pp. 93-95 ◽  
Author(s):  
J P Ludemann ◽  
K Poskitt ◽  
A Singhal
Keyword(s):  
Intracranial Hypertension ◽  
World Literature ◽  
Epidural Abscess ◽  
Acute Otitis Media ◽  
Sigmoid Sinus ◽  
Sinus Wall ◽  
Group A ◽  
Aggressive Debridement ◽  
Symptoms And Signs

AbstractObjective:We present an extremely rare case of severe intracranial hypertension secondary to sigmoid sinus compression by a group A streptococcal epidural abscess.Method:Case report and review of the world literature.Results:A five-year-old boy was treated for acute otitis media and group A streptococcal bacteraemia, but subsequently developed severe intracranial hypertension. Computed tomography revealed that, although the sigmoid sinuses were not thrombosed, the patient had a dominant right sigmoid sinus that was almost completely compressed by a small epidural abscess. After surgical decompression of the epidural abscess, with aggressive debridement of the granulation tissue from the sigmoid sinus wall, the patient awoke from general anaesthesia with complete resolution of his symptoms and signs of intracranial hypertension. He suffered no sequelae over the subsequent six months' follow up.Conclusion:This is the first reported case of intracranial hypertension due to an epidural abscess causing sigmoid sinus compression without thrombosis. This case illustrates the fact that, even in the absence of thrombosis of the sigmoid sinus, a small epidural abscess may require urgent surgical treatment.

Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus

1996 ◽  
Vol 84 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Tetsuya Morimoto ◽  
Hiroyuki Nakase ◽  
Toshio Kakizaki ◽  
Kiyoshi Nagata
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Sinus Thrombosis ◽  
Sigmoid Sinus ◽  
Tumor Surgery ◽  
Content Type ◽  
Sinus Wall ◽  
Before And After ◽  
Tumor Involvement ◽  
Fine Print

✓ In this article, the authors present five cases of dural arteriovenous fistula (AVF) that developed in the transverse—sigmoid sinus 2 to 6 years after sacrifice of the sigmoid sinus because of tumor involvement. The original tumor was meningioma in two patients and neurinoma, glomus jugulare tumor, and ameloblastoma in one patient each. The involved sigmoid sinus was resected along with the tumor and ligated at the normal edge; all that remained of the sigmoid sinus was a small stump on the retrosigmoid portion. Serial angiography performed before and after tumor surgery revealed no abnormal arteriovenous communications or dural AVF in any of the cases. Although many reports have suggested that sinus thrombosis is a precipitating factor in the pathogenesis of dural AVFs, this has been difficult to verify because of the small number of cases in which serial angiography was performed before the development of a dural AVF. In all of the cases presented in this article, surgical resection of a dural AVF and histological examination were performed. Subintimal fibrous thickening was marked, and the sinus wall was found to contain many dural vessels. Organized thrombosis with neovascularization was seen in only two patients. These cases demonstrate that subintimal fibrous thickening and a hypertrophied sinus wall secondary to increased intrasinus pressure or sinus thrombosis occurring after sinus occlusion can provoke the development of a dural AVF within the course of a lifetime. Maintenance of intrasinus blood flow may be very important to prevent this late postoperative complication.

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