Abstract
Major bleeding during stapes surgery is a rare condition. The anterior course of the sigmoid sinus is comparatively common in contracted mastoid bones, but rare in good pneumatized temporal bones. We report a case of an unusual anterior course of the vertical segment of the sigmoid sinus, which led to profuse bleeding during a stapedotomy operation. The 34-year-old female patient presented with conductive-type hearing loss in the right ear. During the operation, the unintentional sliding movement of a blunt curette caused injury to the anteriorly positioned sigmoid sinus, which was separated from the posterior wall of the external auditory canal by an extremely thin shell of bone. Profuse bleeding from the sigmoid sinus was controlled by pushing the middle part of the oxidised regenerated cellulose inside the lumen, without compromising the sinus flow. After bleeding was restrained, the stapedotomy operation was completed successfully. During the 1-year follow-up, there was neither an air-bone gap nor a sensorineural hearing loss in pure tone audiogram.
Similar content being viewed by others
References
Aslan A, Kobayashi T, Diop D, Balyan FR, Russo A, Taibah A (1996) Anatomical relationship between position of the sigmoid sinus and regional mastoid pneumatization. Eur Arch Otorhinolaryngol 253:450–453
Dora F, Zileli T (1980) Common variations of the lateral and occipital sinuses at the confluence sinuum. Neuroradiology 20:23–27
Ichijo H, Hosokowa M, Shinkawa H (1993) Differences in size and shape between the right and left sigmoid sinuses. Eur Arch Otorhinolaryngol 250:297–299
Meltzer PE, Lindsay JR, Goodhill V, et al, Symposium (1956) The operation for the mobilization of the stapes in otosclerotic deafness. Laryngoscope 66:729–784
Orr JB, Todd NW (1988) Jugular bulb position and shape are unrelated to temporal bone pneumatization. Laryngoscope 98:136–138
Sekhar LN, Tzortzidis FN, Bejjani GK, Schessel DA (1997) Saphenous vein graft bypass of the sigmoid sinus and jugular bulb during the removal of glomus jugulare tumours. J Neurosurg 86:1036–1041
Shatz A, Sadé J (1990) Correlation between mastoid pneumatization and position of the lateral sinus. Ann Otol Rhinol Laryngol 99:142–145
Shea JJ (1963) Complications of the stapedectomy operation. Ann Otol Rhinol Laryngol 72:1109–1123
Shea JJ (1998) Forty years of stapes surgery. Am J Otol 19:52–55
Turgut S, Tos M (1992) Correlation between temporal bone pneumatization, location of lateral sinus and length of the mastoid process. J Laryngol Otol 106:485–489
Wiet RJ, Harvey SA, Bauer GP (1993) Complications in stapes surgery—options for prevention and management. Otolaryngologic Clin North Am 26:471–490
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ulug, T., Basaran, B., Minareci, O. et al. An unusual complication of stapes surgery: profuse bleeding from the anteriorly located sigmoid sinus. Eur Arch Otorhinolaryngol 261, 397–399 (2004). https://doi.org/10.1007/s00405-003-0655-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-003-0655-2