Clinical characteristics of pulsatile tinnitus caused by sigmoid sinus diverticulum and wall dehiscence: a study of 54 patients

Abstract

Conclusions: CT angiography (CTA) and digital subtraction angiography (DSA) are valuable tools in imaging work-ups for the diagnosis of sigmoid sinus diverticulum (SSD) and sigmoid sinus wall dehiscence (SSWD). The development of pulsatile tinnitus (PT) resulting from SSD and SSWD may be associated with the dominance of venous systems. Objective: Our goal was to evaluate the clinical characteristics of PT caused by SSD and SSWD. Methods: This was a retrospective chart review undertaken in a tertiary academic referral center. Fifty-four patients with PT due to SSD and SSWD were recruited. Hospital files of these patients were assessed. Data included medical history, physical examinations, auxiliary examinations, and radiographic findings of CTA and DSA. Results: The study population comprised 51 females and 3 males. Most patients with PT caused by SSD and SSWD were middle-aged women. All had normal otoscopy results. Anomalies occurred in or adjacent to the region of the transverse–sigmoid sinus junction in 52 patients. Half of the patients (27/54) presented abnormal results of examination of blood lipids. There were 57.41% (31/54) cases with ipsilateral dominance of the venous system, 9.26% (5/54) cases with contralateral dominance, and 33.33% (18/54) cases with co-dominance of the venous system.

Keywords::

• CT angiography
• digital subtraction angiography

Acknowledgments

This work was supported by grant no. 2012BA112B05 from the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period of China, grant no. 81171311 from the National Natural Science Foundation of China, grant no. KZ20110025029 from the Beijing Municipal Commission of Education, grant no. D101100050010031 from the Beijing Municipal Science and Technology Commission, and grant no. 13JL03 from Capital Medical University of China.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.