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Sigmoid sinus diverticulum and pulsatile tinnitus: analysis of CT scans from 15 cases

2013; SAGE Publishing; Volume: 54; Issue: 7 Linguagem: Inglês

10.1177/0284185113481698

1600-0455

Zhaohui Liu, Cheng-Fang Chen, Zhenchang Wang, Shusheng Gong, Junfang Xian, Yongzhe Wang, Xihong Liang, Xiaobo Ma, Yi Li,

Trigeminal Neuralgia and Treatments

Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established.To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT.Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization.Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively.Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum.