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Physical and psychological outcomes of simple sigmoid sinus bony wall repair for pulsatile tinnitus due to sigmoid sinus wall anomalies

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Pulsatile tinnitus (PT) due to sigmoid sinus wall anomalies (SSWA) is a common health disorder. The purpose of this study is to investigate the efficiency of simple sigmoid sinus bony wall repair on tinnitus relief and psychological improvement.

Methods

Nine cases of PT due to SSWA were retrospectively reviewed. All of these cases had defect of sigmoid sinus bony wall with or without diverticulum in high-resolution CT. The bony defects were repaired by multi-layer materials, i.e., temporalis fascia, bone dust and another layer of bone dust. The assessment of visual analog scale (VAS) of tinnitus and Mandarin version of the tinnitus questionnaire (MTQ) were carried out before operation and at 1 week, 3 months, 6 months and 12 months after operation.

Results

All of eight cases treated by simple sigmoid sinus bony wall repair reported disappearance or significant relief of PT after operation. The VAS and MTQ scores at 1 week, 3 months, 6 months and 12 months after operation all significantly decreased when compared to that before operation (p < 0.05).

Conclusion

Simple repair of sigmoid sinus bony wall defects was an effective way to reduce the physical impact as well as the psychological impact of PT due to SSWA. The defect of sigmoid sinus bony wall played a key role in the pathophysiology of PT due to SSWA.

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References

  1. Liyanage SH, Singh A, Savundra P, Kalan A (2006) Pulsatile tinnitus. J Laryngol Otol 120(2):93–97. https://doi.org/10.1017/s0022215105001714

    Article  CAS  PubMed  Google Scholar 

  2. Holgate RC, Wortzman G, Noyek AM, Makerewicz L, Coates RM (1977) Pulsatile tinnitus: the role of angiography. J Otolaryngol Suppl 3:49–62

    CAS  PubMed  Google Scholar 

  3. Mattox DE, Hudgins P (2008) Algorithm for evaluation of pulsatile tinnitus. Acta Otolaryngol 128(4):427–431. https://doi.org/10.1080/00016480701840106

    Article  PubMed  Google Scholar 

  4. Miller TR, Serulle Y, Gandhi D (2016) Arterial abnormalities leading to tinnitus. Neuroimaging Clin N Am 26(2):227–236. https://doi.org/10.1016/j.nic.2015.12.002 (%/Copyright (c) 2016 Elsevier Inc. All rights reserved)

    Article  PubMed  Google Scholar 

  5. Hofmann E, Behr R, Neumann-Haefelin T, Schwager K (2013) Pulsatile tinnitus: imaging and differential diagnosis. Dtsch Arztebl Int 110(26):451–458. https://doi.org/10.3238/arztebl.2013.0451

    Article  PubMed  PubMed Central  Google Scholar 

  6. Schoeff S, Nicholas B, Mukherjee S, Kesser BW (2014) Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus. Otolaryngol Head Neck Surg 150(5):841–846. https://doi.org/10.1177/0194599813520291

    Article  PubMed  Google Scholar 

  7. Otto KJ, Hudgins PA, Abdelkafy W, Mattox DE (2007) Sigmoid sinus diverticulum: a new surgical approach to the correction of pulsatile tinnitus. Otology and neurotology: official publication of the American otological society. Am Neurotol Soc Eur Acad Otol Neurotol 28(1):48–53. https://doi.org/10.1097/01.mao.0000247814.85829.f6

    Article  Google Scholar 

  8. Sanchez TG, Murao M, de Medeiros IR, Kii M, Bento RF, Caldas JG, Alvarez CA, Raggiotto CH (2002) A new therapeutic procedure for treatment of objective venous pulsatile tinnitus. Int Tinnitus J 8(1):54–57

    PubMed  Google Scholar 

  9. Eisenman DJ (2011) Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings. Otology and neurotology: official publication of the American Otological Society. Am Neurotol Soc Eur Acad Otol Neurotol 32(7):1116–1119. https://doi.org/10.1097/MAO.0b013e31822a1c7d

    Article  Google Scholar 

  10. Xue J, Li T, Sun X, Liu Y (2012) Focal defect of mastoid bone shell in the region of the transverse-sigmoid junction: a new cause of pulsatile tinnitus. J Laryngol Otol 126(4):409–413. https://doi.org/10.1017/s0022215111003458

    Article  CAS  PubMed  Google Scholar 

  11. Wang GP, Zeng R, Liu ZH, Liang XH, Xian JF, Wang ZC, Gong SS (2014) Clinical characteristics of pulsatile tinnitus caused by sigmoid sinus diverticulum and wall dehiscence: a study of 54 patients. Acta Otolaryngol 134(1):7–13. https://doi.org/10.3109/00016489.2013.831479

    Article  PubMed  Google Scholar 

  12. Harvey RS, Hertzano R, Kelman SE, Eisenman DJ (2014) Pulse-synchronous tinnitus and sigmoid sinus wall anomalies: descriptive epidemiology and the idiopathic intracranial hypertension patient population. Otology & neurotology: official publication of the American otological society. Am Neurotol Soc Eur Acad Otol Neurotol 35(1):7–15. https://doi.org/10.1097/MAO.0b013e3182a4756c

    Article  Google Scholar 

  13. Zeng R, Wang GP, Liu ZH, Liang XH, Zhao PF, Wang ZC, Gong SS (2016) Sigmoid sinus wall reconstruction for pulsatile tinnitus caused by sigmoid sinus wall dehiscence: a single-center experience. PLoS One 11(10):e0164728. https://doi.org/10.1371/journal.pone.0164728

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Song JJ, Kim YJ, Kim SY, An YS, Kim K, Lee SY, Koo JW (2015) Sinus wall resurfacing for patients with temporal bone venous sinus diverticulum and ipsilateral pulsatile tinnitus. Neurosurgery 77(5):709–717. https://doi.org/10.1227/neu.0000000000000902 (discussion 717).

    Article  PubMed  Google Scholar 

  15. Friedmann DR, Eubig J, McGill M, Babb JS, Pramanik BK, Lalwani AK (2011) Development of the jugular bulb: a radiologic study. Otology and neurotology: official publication of the American otological society. Am Neurotol Soc Eur Acad Otol Neurotol 32(8):1389–1395. https://doi.org/10.1097/MAO.0b013e31822e5b8d

    Article  Google Scholar 

  16. Wang GP, Zeng R, Ma XB, Liu ZH, Wang ZC, Gong SS (2015) Surgical treatment of pulsatile tinnitus caused by the sigmoid sinus diverticulum: a preliminary study. Medicine (Baltim) 94(21):e882. https://doi.org/10.1097/md.0000000000000882

    Article  Google Scholar 

  17. Guo P, Wang WQ (2015) Degree of sigmoid sinus compression and the symptom relief using magnetic resonance angiography in venous pulsating tinnitus. Clin Exp Otorhinolaryngol 8(2):111–116. https://doi.org/10.3342/ceo.2015.8.2.111

    Article  PubMed  PubMed Central  Google Scholar 

  18. Wee JH, Song JJ, Koo JW, Kim CS (2012) Increased intracranial pressure after surgical treatment of pulsatile tinnitus from a prominent sigmoid sinus. Otol Neurotol 33 (6):e41-42. https://doi.org/10.1097/MAO.0b013e318245cb22

    Article  Google Scholar 

  19. Giuseffi V, Wall M, Siegel PZ, Rojas PB (1991) Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri): a case-control study. Neurology 41(2 Pt 1):239–244

    Article  CAS  PubMed  Google Scholar 

  20. Houdart E, Chapot R, Merland JJ (2000) Aneurysm of a dural sigmoid sinus: a novel vascular cause of pulsatile tinnitus. Ann Neurol 48(4):669–671

    Article  CAS  PubMed  Google Scholar 

  21. Sismanis A (1998) Pulsatile tinnitus. A 15-year experience. Am J Otol 19(4):472–477

    CAS  PubMed  Google Scholar 

  22. Paramasivam S, Furtado S, Shigamatsu T, Smouha E (2016) Endovascular management of sigmoid sinus diverticulum. Interv Neurol 5(1–2):76–80. https://doi.org/10.1159/000444507

    Article  PubMed  PubMed Central  Google Scholar 

  23. Li B, Lv X, Wu Z, Cao X, Wang J, Ge A, Liu X, Li S (2016) Stent-assisted coil embolization of a transverse-sigmoid sinus diverticulum presenting with pulsatile tinnitus. Turk Neurosurg 26(4):632–634. https://doi.org/10.5137/1019-5149.jtn.8140-13.3

    Article  PubMed  Google Scholar 

  24. Santos-Franco JA, Lee A, Nava-Salgado G, Zenteno M, Vega-Montesinos S, Pane-Pianese C (2012) Hybrid carotid stent for the management of a venous aneurysm of the sigmoid sinus treated by sole stenting. Vasc Endovascular Surg 46(4):342–346. https://doi.org/10.1177/1538574412442593

    Article  CAS  PubMed  Google Scholar 

  25. Gologorsky Y, Meyer SA, Post AF, Winn HR, Patel AB, Bederson JB (2009) Novel surgical treatment of a transverse-sigmoid sinus aneurysm presenting as pulsatile tinnitus: technical case report. Neurosurgery 64(2):E393–E394. https://doi.org/10.1227/01.neu.0000338255.93266.00 (discussion E394).

    Article  PubMed  Google Scholar 

  26. Park JH, Noh TS, Lee JH, Oh SH, Kim JS, Chung CK, Suh MW (2015) Difference in Tinnitus Treatment Outcome According to the Pulse Number of Repetitive Transcranial Magnetic Stimulation. Otol Neurotol 36(8):1450–1456. https://doi.org/10.1097/mao.0000000000000802

    Article  PubMed  Google Scholar 

  27. Kim DK, Park SN, Kim MJ, Lee SY, Park KH, Yeo SW (2011) Tinnitus in patients with chronic otitis media before and after middle ear surgery. Eur Arch Otorhinolaryngol 268(10):1443–1448. https://doi.org/10.1007/s00405-011-1519-9

    Article  PubMed  Google Scholar 

  28. Meng Z, Chen Z, Xu K, Li G, Tao Y, Kwong JS (2016) Psychometric properties of a Mandarin version of the tinnitus questionnaire. Int J Audiol 55(6):366–374. https://doi.org/10.3109/14992027.2016.1146414

    Article  PubMed  Google Scholar 

  29. Wang AC, Nelson AN, Pino C, Svider PF, Hong RS, Chan E (2017) Management of sigmoid sinus associated pulsatile tinnitus: a systematic review of the literature. Otol Neurotol 38(10):1390–1396. https://doi.org/10.1097/MAO.0000000000001612

    Article  PubMed  Google Scholar 

  30. Navsa N, Kramer B (1998) A quantitative assessment of the jugular foramen. Ann Anat 180(3):269–273. https://doi.org/10.1016/s0940-9602(98)80086-1

    Article  CAS  PubMed  Google Scholar 

  31. Kim CS, Kim SY, Choi H, Koo JW, Yoo SY, An GS, Lee K, Choi I, Song JJ (2016) Transmastoid reshaping of the sigmoid sinus: preliminary study of a novel surgical method to quiet pulsatile tinnitus of an unrecognized vascular origin. J Neurosurg 125(2):441–449. https://doi.org/10.3171/2015.6.JNS15961

    Article  PubMed  Google Scholar 

  32. Eisenman DJ, Raghavan P, Hertzano R, Morales R (2018) Evaluation and treatment of pulsatile tinnitus associated with sigmoid sinus wall anomalies. The Laryngoscope 128(Suppl 2):S1–S13. https://doi.org/10.1002/lary.27218

    Article  PubMed  Google Scholar 

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Correspondence to Shufeng Li.

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Zhang, C., Li, Q. & Li, S. Physical and psychological outcomes of simple sigmoid sinus bony wall repair for pulsatile tinnitus due to sigmoid sinus wall anomalies. Eur Arch Otorhinolaryngol 276, 1327–1334 (2019). https://doi.org/10.1007/s00405-019-05380-1

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