Mu Zhenxia, Zhuang Lihui, Zhao Pengfei, Gao Bin, Liu Youjun, Wang Zhenchang, Yang Shifeng, Wang Ximing
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Bioengineering (Basel). 2023 Jun 12;10(6):715. doi: 10.3390/bioengineering10060715.
Sigmoid sinus wall dehiscence (SSWD) is an important etiology of venous pulsatile tinnitus (VPT) and is treated by sigmoid sinus wall reconstruction (SSWR). This study aimed to investigate the therapeutic effects of the different degrees of SSWR and the prognostic effect in patients with VPT. Personalized models of three patients with SSWD (control), 3/4SSWD, 1/2SSWD, 1/4SSWD, and 0SSWD were reconstructed. A multiphysics interaction approach was applied to elucidate the biomechanical and acoustic changes. Results revealed that after SSWR, the average pressure of venous vessel on the SSWD region reduced by 33.70 ± 12.53%, 35.86 ± 12.39%, and 39.70 ± 12.45% (mean ± SD) in three patients with 3/4SSWD, 1/2SSWD, and 1/4SSWD. The maximum displacement of the SSWR region reduced by 25.91 ± 30.20%, 37.20 ± 31.47%, 52.60 ± 34.66%, and 79.35 ± 18.13% (mean ± SD) in three patients with 3/4SSWD, 1/2SSWD, 1/4SSWD, and 0SSWD, with a magnitude approximately 10 times that of the venous vessel in the SSWD region. The sound pressure level at the tympanum reduced by 23.72 ± 1.91%, 31.03 ± 14.40%, 45.62 ± 19.11%, and 128.46 ± 15.46% (mean ± SD). The SSWR region was still loaded with high stress in comparison to the surrounding region. The SSWR region of the temporal bone effectively shielded the high wall pressure and blocked the transmission of venous vessel vibration to the inner ear. Patients with inadequate SSWR still had residual VPT symptoms despite the remission of VPT symptoms. Complete SSWR could completely solve VPT issues. High-stress distribution of the SSWR region may be the cause of the recurrence of VPT symptoms.
乙状窦壁骨质缺损（SSWD）是静脉搏动性耳鸣（VPT）的重要病因，可通过乙状窦壁重建术（SSWR）进行治疗。本研究旨在探讨不同程度的SSWR对VPT患者的治疗效果及预后影响。重建了3例SSWD患者（对照组）、3/4SSWD、1/2SSWD、1/4SSWD和0SSWD患者的个性化模型。采用多物理场相互作用方法阐明生物力学和声学变化。结果显示，在进行SSWR后，3例3/4SSWD、1/2SSWD和1/4SSWD患者乙状窦壁骨质缺损区域静脉血管的平均压力分别降低了33.70±12.53%、35.86±12.39%和39.70±12.45%（平均值±标准差）。3例3/4SSWD、1/2SSWD、1/4SSWD和0SSWD患者乙状窦壁重建区域的最大位移分别降低了25.91±30.20%、37.20±31.47%、52.60±34.66%和79.35±18.13%（平均值±标准差），其幅度约为乙状窦壁骨质缺损区域静脉血管的10倍。鼓膜处的声压级分别降低了23.72±1.91%、31.03±14.40%、45.62±19.11%和128.46±15.46%（平均值±标准差）。与周围区域相比，乙状窦壁重建区域仍承受着高应力。颞骨的乙状窦壁重建区域有效地屏蔽了高壁压力，并阻断了静脉血管振动向内耳的传递。尽管VPT症状有所缓解，但乙状窦壁重建不充分的患者仍有残留的VPT症状。完全的乙状窦壁重建可以彻底解决VPT问题。乙状窦壁重建区域的高应力分布可能是VPT症状复发的原因。
