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Treatment of pulsatile tinnitus caused by anomalies of the sigmoid sinus wall via combined internal and external sigmoid sinus wall reconstruction with 3D temporal bone CT guidance

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

Abstract

Purpose

The present analysis aims to describe a surgical approach wherein pulsatile tinnitus (PT) arising due to sigmoid sinus wall anomalies (SSWA) can be treated via combination internal and external sigmoid sinus wall reconstruction. We further evaluated the utility of temporal bone 3D-CT imaging during both the pre- and post-operative assessments of all treated patients.

Methods

Data pertaining to 11 patients that had undergone sigmoid sinus wall reconstruction were retrospectively analyzed. All of these patients underwent preoperative 3D-CT imaging assessment. These patients were additionally subjected to sigmoid sinus wall reconstruction via a combined internal and external layer approach. Postoperatively, all patients underwent a radiological assessment of auricular cartilage and autologous bone powered displacement. Patients were additionally asked about any subjective changes in PT or associated symptoms at follow-up time points.

Results

SSWA in the 3D-CT imaging from these patients were all distinct. In 10/11 patients, PT fully resolved following reconstruction of the sinus wall. The remaining patients exhibited significant improvements in symptoms postoperatively, with PT fully resolving within a 1-month follow-up period. No patients suffered any major complications.

Conclusions

Temporal bone 3D-CT imaging allow for effective visualization of SSWA, enabling effective pre- and post-operative assessments of treated patients. A combined internal and external layer approach to sigmoid sinus wall reconstruction can be implemented safely and effectively, yielding high rates of satisfactory outcomes and achieving rigid reconstruction of this surface. As such, there is clear value in the consideration of this approach when treating individuals suffering from PT as a result of SSWA.

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, 230022, Anhui, China

    Dong Wang, Yi Zhao & Busheng Tong

Authors
  1. Dong Wang
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  2. Yi Zhao
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  3. Busheng Tong
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by DW, YZ and BT. The first draft of the manuscript was written by DW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Busheng Tong.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The First Affiliated Hospital of Anhui Medical University approved this study.

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data and photographs.

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The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

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Cite this article

Wang, D., Zhao, Y. & Tong, B. Treatment of pulsatile tinnitus caused by anomalies of the sigmoid sinus wall via combined internal and external sigmoid sinus wall reconstruction with 3D temporal bone CT guidance. Eur Arch Otorhinolaryngol 277, 2439–2445 (2020). https://doi.org/10.1007/s00405-020-05989-7

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  • DOI: https://doi.org/10.1007/s00405-020-05989-7

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