*Department of Otolaryngology, Georgetown University Hospital; †Department of Radiology, Howard University Hospital; and ‡Department of Radiology, Georgetown University Hospital, Washington, District of Columbia, U.S.A.
Otol Neurotol. 2014 Jan;35(1):16-21. doi: 10.1097/MAO.0b013e31829ab6d7.
Sigmoid sinus diverticulum/dehiscence (SSDD) is an increasingly recognized venous cause for pulsatile tinnitus (PT). SSDD is amenable to surgical/endovascular intervention. We aim to understand the clinical and imaging features of patients with PT due to SSDD.
Retrospective CT study and chart review.
Tertiary-care, academic center.
Cohort 1: 200 consecutive unique temporal bone CT were blindly reviewed for anatomic findings associated with PT. Cohort 2: 61 patients with PT were evaluated for otologic manifestations.
INTERVENTION(S): All patients underwent a temporal bone CT for evaluation of PT. Clinical information was gathered using electronic medical records.
MAIN OUTCOME MEASURE(S): Otologic symptoms and physical findings (including body mass index (BMI), mastoid/neck bruits) were analyzed. Temporal bone CT scans were evaluated for the presence of SSDD and other possible causes of PT.
Cohort 1: 35 cases of SSDD were identified (18%); 10 (29%) true diverticula; and 25 (71%) dehiscence. Sixty-six percent were right sided. Twelve patients had PT (34%). Patients with SSDD are more likely to have PT (p = 0.003). A significant association between right SSDD and PT was found (p = 0.001). Cohort 2: 15 out of 61 patients had PT and CT-confirmed SSDD. All were female subjects; average age was 45 years (26-73 yr). Radiologic evaluation revealed 10 SSDD cases on the right (66.7%), 2 on the left (13.3%%), and 3 bilateral (20%). Sensorineural hearing loss was seen in 8 (53%), aural fullness in 12 (80%). Average BMI was 32.2 (21.0-59.82), and 4 (26%) had audible mastoid bruits.
SSDD may be the most common identifiable cause for PT from venous origin and is potentially treatable. Temporal bone CT scans should be included in a complete evaluation of PT.
乙状窦憩室/裂（SSDD）是引起搏动性耳鸣（PT）的一种日益被认识到的静脉性病因。SSDD 可通过手术/血管内干预治疗。我们旨在了解因 SSDD 引起的 PT 患者的临床和影像学特征。
回顾性 CT 研究和图表回顾。
三级保健，学术中心。
队列 1：200 例连续的颞骨 CT 盲法复查，以寻找与 PT 相关的解剖学发现。队列 2：61 例 PT 患者评估耳科表现。
所有患者均行颞骨 CT 检查以评估 PT。使用电子病历收集临床信息。
耳科症状和体征（包括体重指数（BMI）、乳突/颈部杂音）进行分析。颞骨 CT 扫描评估 SSDD 及其他可能引起 PT 的原因。
队列 1：发现 35 例 SSDD（18%）；10 例（29%）真性憩室；25 例（71%）裂。66%为右侧。12 例患者有 PT（34%）。有 SSDD 的患者更有可能出现 PT（p = 0.003）。发现右侧 SSDD 与 PT 之间存在显著关联（p = 0.001）。队列 2：61 例患者中有 15 例经 CT 证实为 SSDD 伴 PT。均为女性患者；平均年龄 45 岁（26-73 岁）。影像学评估显示右侧 SSDD 10 例（66.7%），左侧 2 例（13.3%），双侧 3 例（20%）。感音神经性听力损失 8 例（53%），耳闷 12 例（80%）。平均 BMI 为 32.2（21.0-59.82），4 例（26%）可闻及乳突杂音。
SSDD 可能是静脉性起源引起 PT 的最常见可识别病因，且具有潜在的可治疗性。颞骨 CT 扫描应纳入 PT 全面评估中。
