Highlights
- •Novel grading system for sigmoid sinus dehiscence based on size and location.
- •Sigmoid sinus dehiscence up to 7.5 mm may be a normal variant in asymptomatic patients.
- •Sigmoid sinus dehiscence found on CT scan in 34% of asymptomatic cohort.
Abstract
Background
Sigmoid sinus dehiscence (SSD) is an important etiology of pulsatile tinnitus (PT)
though there is currently no consensus on the prevalence of SSD in non-PT populations.
This study establishes a grading system of SSD and analyzes a non-PT cohort for prevalence
of SSD.
Methods
In this retrospective study temporal bone CT scans of 91 patients without PT were
analyzed for SSD. The dehiscence was divided into three grades: Grade 1 indicating
a micro dehiscence of <3.5 mm with an opening to the mastoid air cells, Grade 2 indicating
a major dehiscence of >3.5 mm with an opening to the mastoid air cells, and Grade
3 indicating a sigmoid sinus wall dehiscence opening directly to the underlying tissue.
Results
In patients without PT, SSD occurred in 34% of the cohort. Of these, 75% were Grade
1 and 25% were Grade 2. The range of dehiscence measurements for Grade 1 dehiscences
was 0.9–3.4 mm. The range of dehiscence measurements for Grade 2 was 4–7.5 mm. There
were no cases of Grade 3 dehiscence among this cohort.
Conclusions
SSD occurred in over a third of our non-symptomatic cohort. While all grades of SSD
may currently be treated surgically, a large portion of non-PT patients may have these
sigmoid sinus anomalies asymptomatically. This grading system allows for the standardization
of SSD definition and severity in future studies. Grade 3 dehiscences were completely
absent in this cohort of non-PT patients.
Keywords
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References
- Prevalence and characteristics of tinnitus among US adults.Am J Med. 2010; 123: 711-718
- J Laryngol Otol. 2007; 121: 201-208
- Imaging in pulsatile tinnitus.Clin Radiol. 2009; 64: 319-328
- Pulsatile tinnitus: contemporary assessment and management.Curr Opin Otolaryngol Head Neck Surg. 2011; 19: 348-357
- Clinical presentation and imaging findings in patients with pulsatile tinnitus and sigmoid sinus diverticulum/dehiscence.Otol. Neurotol. 2014; 35: 16-21
- Algorithm for evaluation of pulsatile tinnitus.Acta Otolaryngol. 2008; 128: 427-431
- Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings.Otol Neurotol. 2011; 32: 1116-1119
- Novel surgical treatment of a transverse-sigmoid sinus aneurysm presenting as pulsatile tinnitus: technical case report.Neurosurgery. 2009; 64: E393-E394
- Postoperative imaging findings following sigmoid sinus wall reconstruction for pulse synchronous tinnitus.Am J Neuroradiol. 2016; 37: 136-142
- Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus.Otolaryngol Head Neck Surg. 2014; 150: 841-846
Article info
Publication history
Accepted:
February 18,
2021
Received:
December 15,
2020
Identification
Copyright
© 2021 Published by Elsevier Ltd.
