Association between sigmoid sinus with focal dehiscence and the natural history of pulsatile tinnitus

SUN Xingwang; CUI Bao; XU Weifeng; DU Yiping; ZHU Yufen; KANG Yunhui; ZHOU Yongqing; CUI Jinguo

Abstract：Objective To investigate the temporal bone CT characteristics of pulsatile tinnitus (PT) because of sigmoid sinus with focal dehiscence (SSD), as well as the relationships between SSD and the natural history.Methods 13 cases cured by sigmoid sinus wall reconstruction were recruited, a retrospective analysis of the preoperative temporal bone high resolution CT imaging (TB-HRCT) and the related clinical history was performed.We determined the position of SSD and measured the maximum length on the multiplanar reconstruction image, and determined whether with sigmoid sinus diverticulum, high jugular ball and mastoid guide venous malformations, and analyzed the relationship between SSD and the course.Results All the cases were female, with a mean age of (34.31±11.56) years, natural history of (4.44±3.28) years (range 4 months~10 years), 11 cases were on the right side, and 2 cases on the left.8 cases presented with sigmoid sinus diverticulum.SSD located in the anterolateral wall of transverse-sigmoid sinus, average length was (5.32±2.28) mm.Multiple factor correlation analysis indicated that the length of SSD mainly determined by the history of PT (P=0.007<0.05).The length of the SSD was highly associated with natural history of PT(r=0.825, P=0.001<0.05).SSD was demonstrated a good interobserver agreement.Conclusion SSD may be progressive, the natural history of PT is longer, the length of the SSD is bigger.Via the TB-HRCT, the SSD can be fully displayed that will be meaningful for the preoperative guidance.