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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Dynamic Volume Computed Tomography for Characterizing Pulsatile Tinnitus Caused by Sigmoid Sinus Diverticulum with Bone Defects: Clinical Implications

Author(s): Jie Zhang, Quan-Liang Mao, Fang-Jie Shen, Yu-Ning Pan* and Ai-Jing Li*

Volume 18, Issue 14, 2022

Published on: 07 July, 2022

Article ID: e090522204491 Pages: 7

DOI: 10.2174/1573405618666220509210917

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Abstract

Objective: The objective of this study is to investigate the diagnosis of dynamic volume computed tomography (CT) for pulsatile tinnitus caused by sigmoid sinus diverticulum (SSD) and bone defects.

Methods: Data obtained by dynamic volume CT from 35 patients with SSD were retrospectively collected. Then the ear morphological parameters, including bone defect, transverse sinus stenosis, position of the jugular bulb, jugular bulb diverticulum, defect of the jugular bulb wall, gross venous sinus thrombosis and SSD, and blood perfusion parameters, including cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT), were evaluated and compared between the tinnitus side and the asymptomatic side of the ear.

Results: The maximum diameters of the bone defects on the tinnitus side were greater than those on the asymptomatic side (Horizontal 6.36±2.35mm vs. 1.12±0.78mm; Longitudinal 4.87±1.25 vs. 0.88±0.06mm). Dynamic volume CT visually displayed the SSD herniated into the adjacent mastoid via the bone defect. Transverse sinus stenosis, high position of the jugular bulb, jugular bulb diverticulum, defect of the jugular bulb wall, and gross venous sinus thrombosis were present more frequently on the tinnitus side than on the asymptomatic side (P < 0.05). Moreover, CBF, CBV, and MTT were significantly greater on the tinnitus side than on the asymptomatic side (P < 0.05).

Conclusion: Dynamic volume CT examination is an effective method for the diagnosis of pulsatile tinnitus caused by SSD with bone defects.

Keywords: Pulsatile tinnitus, sigmoid sinus, diverticulum, blood perfusion, dynamic volume CT, bone defect.

Graphical Abstract

[1]
Baguley D, McFerran D, Hall D. Tinnitus. Lancet 2013; 382(9904): 1600-7.
[http://dx.doi.org/10.1016/S0140-6736(13)60142-7] [PMID: 23827090]
[2]
Levine RA, Oron Y. Tinnitus. Handb Clin Neurol 2015; 129(1): 409-31.
[http://dx.doi.org/10.1016/B978-0-444-62630-1.00023-8] [PMID: 25726282]
[3]
Hofmann E, Behr R, Neumann-Haefelin T, Schwager K. Pulsatile tinnitus: Imaging and differential diagnosis. Dtsch Arztebl Int 2013; 110(26): 451-8.
[PMID: 23885280]
[4]
Wang GP, Zeng R, Liu ZH, et al. Clinical characteristics of pulsatile tinnitus caused by sigmoid sinus diverticulum and wall dehiscence: A study of 54 patients. Acta Otolaryngol 2014; 134(1): 7-13.
[http://dx.doi.org/10.3109/00016489.2013.831479] [PMID: 24032538]
[5]
Madani G, Connor SE. Imaging in pulsatile tinnitus. Clin Radiol 2009; 64(3): 319-28.
[http://dx.doi.org/10.1016/j.crad.2008.08.014] [PMID: 19185662]
[6]
Krishnan A, Mattox DE, Fountain AJ, Hudgins PA. CT arteriography and venography in pulsatile tinnitus: Preliminary results. AJNR Am J Neuroradiol 2006; 27(8): 1635-8.
[PMID: 16971601]
[7]
Mundada P, Singh A, Lingam RK. CT arteriography and venography in the evaluation of Pulsatile tinnitus with normal otoscopic examination. Laryngoscope 2015; 125(4): 979-84.
[http://dx.doi.org/10.1002/lary.25010] [PMID: 25379666]
[8]
Amans MR, Haraldsson H, Kao E, et al. MR venous flow in sigmoid sinus diverticulum. AJNR Am J Neuroradiol 2018; 39(11): 2108-13.
[http://dx.doi.org/10.3174/ajnr.A5833] [PMID: 30309843]
[9]
Zhao P, Lv H, Dong C, Niu Y, Xian J, Wang Z. CT evaluation of sigmoid plate dehiscence causing pulsatile tinnitus. Eur Radiol 2016; 26(1): 9-14.
[http://dx.doi.org/10.1007/s00330-015-3827-8] [PMID: 25991486]
[10]
Pegge SAH, Steens SCA, Kunst HPM, Meijer FJA. Pulsatile tinnitus: Differential diagnosis and radiological work-up. Curr Radiol Rep 2017; 5(1): 5.
[http://dx.doi.org/10.1007/s40134-017-0199-7] [PMID: 28203490]
[11]
Otto KJ, Hudgins PA, Abdelkafy W, Mattox DE. Sigmoid sinus diverticulum: A new surgical approach to the correction of pulsatile tinnitus. Otol Neurotol 2007; 28(1): 48-53.
[http://dx.doi.org/10.1097/01.mao.0000247814.85829.f6] [PMID: 17195746]
[12]
Lansley JA, Tucker W, Eriksen MR, Riordan-Eva P, Connor SEJ. Sigmoid sinus diverticulum, dehiscence, and venous sinus stenosis: Potential causes of pulsatile tinnitus in patients with idiopathic intracranial hypertension? AJNR Am J Neuroradiol 2017; 38(9): 1783-8.
[http://dx.doi.org/10.3174/ajnr.A5277] [PMID: 28705815]
[13]
Wang AC, Nelson AN, Pino C, Svider PF, Hong RS, Chan E. Management of sigmoid sinus associated pulsatile tinnitus: A systematic review of the literature. Otol Neurotol 2017; 38(10): 1390-6.
[http://dx.doi.org/10.1097/MAO.0000000000001612] [PMID: 29135862]
[14]
Eisenman DJ, Raghavan P, Hertzano R, Morales R. Evaluation and treatment of pulsatile tinnitus associated with sigmoid sinus wall anomalies. Laryngoscope 2018; 128 (Suppl. 2): S1-S13.
[http://dx.doi.org/10.1002/lary.27218] [PMID: 29756346]
[15]
Sanchez TG, Murao M, de Medeiros IR, et al. A new therapeutic procedure for treatment of objective venous pulsatile tinnitus. Int Tinnitus J 2002; 8(1): 54-7.
[PMID: 14763237]
[16]
Ding H, Zhao P, Lv H, et al. Temporal bone contrast-enhanced high-resolution CT evaluation of pulsatile tinnitus after sigmoid sinus wall reconstruction. Acta Radiol 2019; 60(1): 54-60.
[http://dx.doi.org/10.1177/0284185118773509] [PMID: 29764198]
[17]
Eisenman DJ. Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: A standardized surgical procedure for a range of radiographic findings. Otol Neurotol 2011; 32(7): 1116-9.
[http://dx.doi.org/10.1097/MAO.0b013e31822a1c7d] [PMID: 21799456]
[18]
Sun J, Sun J. Sandwich technique for sigmoid sinus wall reconstruction for treatment of pulsatile tinnitus caused by sigmoid sinus diverticulum/dehiscence. Acta Otolaryngol 2019; 139(12): 1063-6.
[http://dx.doi.org/10.1080/00016489.2019.1668960] [PMID: 31561720]
[19]
Han Y, Yang Q, Yang Z, et al. Computational fluid dynamics simulation of hemodynamic alterations in sigmoid sinus diverticulum and ipsilateral upstream sinus stenosis after stent implantation in patients with pulsatile tinnitus. World Neurosurg 2017; 106: 308-14.
[http://dx.doi.org/10.1016/j.wneu.2017.06.168] [PMID: 28698087]
[20]
Friedmann DR, Eubig J, McGill M, Babb JS, Pramanik BK, Lalwani AK. Development of the jugular bulb: A radiologic study. Otol Neurotol 2011; 32(8): 1389-95.
[http://dx.doi.org/10.1097/MAO.0b013e31822e5b8d] [PMID: 21921860]
[21]
Liu Z, Chen C, Wang Z, et al. Sigmoid sinus diverticulum and pulsatile tinnitus: Analysis of CT scans from 15 cases. Acta Radiol 2013; 54(7): 812-6.
[http://dx.doi.org/10.1177/0284185113481698] [PMID: 23550183]
[22]
Truesdale CM, El-Kashlan HK. Pulsatile tinnitus with imaging. JAMA Otolaryngol Head Neck Surg 2018; 144(5): 451-2.
[http://dx.doi.org/10.1001/jamaoto.2018.0014] [PMID: 29596564]
[23]
Sismanis A. Pulsatile tinnitus: Contemporary assessment and management. Curr Opin Otolaryngol Head Neck Surg 2011; 19(5): 348-57.
[http://dx.doi.org/10.1097/MOO.0b013e3283493fd8] [PMID: 22552697]
[24]
Liess BD, Lollar KW, Christiansen SG, Vaslow D. Pulsatile tinnitus: A harbinger of a greater ill? Head Neck 2009; 31(2): 269-73.
[http://dx.doi.org/10.1002/hed.20851] [PMID: 18642297]
[25]
Mattox DE, Hudgins P. Algorithm for evaluation of pulsatile tinnitus. Acta Otolaryngol 2008; 128(4): 427-31.
[http://dx.doi.org/10.1080/00016480701840106] [PMID: 18368578]
[26]
Schoeff S, Nicholas B, Mukherjee S, Kesser BW. Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus. Otolaryngol Head Neck Surg 2014; 150(5): 841-6.
[http://dx.doi.org/10.1177/0194599813520291] [PMID: 24468899]

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