Postoperative Imaging Findings following Sigmoid Sinus Wall Reconstruction for Pulse Synchronous Tinnitus
Fellows’ Journal Club
Transmastoid sigmoid sinus wall reconstruction (SSWR) is a surgical technique used for the treatment of pulsatile tinnitus arising from sigmoid sinus wall anomalies. In 13 patients, CT and MR imaging examinations were assessed for the characteristics of the materials used for reconstruction, the impact of these on the adjacent sigmoid sinus, and complications. The various materials used for reconstruction (NeuroAlloderm, HydroSet, bone pate) showed characteristic imaging appearances and could be consistently identified. In 5/13 patients, there was extrinsic compression of the sigmoid sinus by graft material. Dural sinus thrombosis occurred in 2 patients. Symptoms requiring postoperative imaging after SSWR include headaches, visual disturbances, and persistent or recurrent tinnitus.
BACKGROUND AND PURPOSE
Transmastoid sigmoid sinus wall reconstruction is a surgical technique increasingly used for the treatment of pulsatile tinnitus arising from sigmoid sinus wall anomalies. The imaging appearance of the temporal bone following this procedure has not been well-characterized. The purpose of this study was to evaluate the postoperative imaging appearance in a group of patients who underwent this procedure.
MATERIALS AND METHODS
The medical records of 40 consecutive patients who underwent transmastoid sigmoid sinus wall reconstruction were reviewed. Thirteen of 40 patients underwent postoperative imaging. Nineteen CT and 7 MR imaging examinations were assessed for the characteristics of the materials used for reconstruction, the impact of these on the adjacent sigmoid sinus, and complications.
Tinnitus resolved in 38 of 40 patients. Nine patients were imaged postoperatively for suspected complications, including dural sinus…