Computational fluid dynamics study of the effect of transverse sinus stenosis on the blood flow pattern in the ipsilateral superior curve of the sigmoid sinus

Han, Yanjing; Xia, Jun; Jin, Long; Qiao, Aike; Su, Ting; Li, ZhenFeng; Xiong, Jianping; Wang, Haochen; Zhang, Zhiyuan

doi:10.1007/s00330-020-07630-x

Cited by 18 publications

(20 citation statements)

References 24 publications

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“…Previous research found that the increase in BFV due to TSS significantly increased the mean wall pressure of SSWA. 7,9 Therefore, wall pressure is affected by both TSS and SSWA in our study, whereas previous studies did not show TSS interference, so the conclusion is not contradictory.…”

Section: Discussioncontrasting

confidence: 68%

“…However, a study showed that only 75% (91/121) of patients experienced the disappear of PT after the SSWA was eliminated, 23 which suggests that TSS and the abnormal hemodynamic status of the transverse sinus-sigmoid sinus may be important factors affecting the clinical efficacy of SSWR. Previous study 7,9 found that for patients with both TSS and SSWA, simply eliminating TSS by endovascular stenting can make the tinnitus symptoms disappear and even prompt the self-repair of the sigmoid sinus wall dehiscence (SSWD).…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Persistent PT often affects patients' mental health and can even lead to suicide. 6 Transverse sinus stenosis (TSS) [7][8][9] and sigmoid sinus wall anomalies (SSWA) 1,2,[10][11][12] are the most common causes of venous PT; because the two often coexist, it is difficult to determine the role of the two possible causes of PT in individual PT patients, which presents many difficulties in the formulation of clinical treatment plans. 2,9,13 It is also know that treating TSS with venous sinus stenting is extremely effective at treating PT with or without SSWA.…”

Section: Introductionmentioning

confidence: 99%

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Study on the correlation between hemodynamic status of the transverse sinus-sigmoid sinus and the clinical efficacy of sigmoid sinus wall reconstruction

Jin

2021

Interv Neuroradiol

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Background and Purpose For patients with pulsatile tinnitus who have both transverse sinus stenosis and sigmoid sinus wall anomalies, sigmoid sinus wall reconstruction surgery is the first-choice treatment when the trans-stenotic pressure gradient less than 10 mmHg. However, not all patients are cured by surgery. We hypothesized the abnormal hemodynamics caused by transverse sinus stenosis is associated with the clinical efficacy of surgery. Methods Eight pulsatile tinnitus patients treated with surgery were retrospectively reviewed (4 rehabilitated, 4 nonrehabilitated). All patients had radiologically diagnosed transverse sinus stenosis and sigmoid sinus wall anomalies. A numerical simulation of the hemodynamics of the transverse sinus-sigmoid sinus was performed using computational fluid dynamics technology. Changes in the blood flow patterns before and after surgery were observed. The blood flow velocity at the stenosis, vorticity of blood flow in the sigmoid sinus and wall pressure distribution in the sigmoid sinus wall anomalies area were compared. Results The blood flow velocity in the stenosis (preoperative P = 0.04, postoperative P = 0.004) and vorticity in the sigmoid sinus (preoperative P = 0.02, postoperative P = 0.007) pre- and post-surgery were significantly higher in the non-rehabilitation group than in the rehabilitation group. No significant difference was found in the wall pressure distribution in the sigmoid sinus wall anomalies area (preoperative P = 0.12, postoperative P = 0.24). Conclusions There is a clear correlation between the abnormal hemodynamic status caused by transverse sinus stenosis and the clinical efficacy of surgery. The blood flow velocity at the stenosis and vorticity of blood flow in the sigmoid sinus are factors influencing the clinical efficacy of surgery.

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Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Study on the correlation between hemodynamic status of the transverse sinus-sigmoid sinus and the clinical efficacy of sigmoid sinus wall reconstruction

Jin

2021

Interv Neuroradiol

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“…This work revealed the biomechanical and acoustic mechanism of FDS in the treatment of patients with PT. Previous studies primarily focused on the hemodynamic aspects of the TS and SS or the acoustic environment of the inner ear, which neglected to establish the relationship between blood flow and the acoustic environment of the inner ear, and lacked to fundamentally demonstrate the induction mechanism of PT 5,12,20 . In this study, multiphysics coupling numerical simulation was used to explain the generation and conduction mechanism of PT.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, new methods such as spring coil and stent are proposed 5,10 . After stent placement in patients with TS stenosis, the hemodynamic status of the SS on the ipsilateral superior curve was effectively improved, and the symptoms of PT disappeared or alleviated 11,12 . The diverticulum was slightly reduced, but the PT symptoms still remained or intermittently recurred when only the stent was placed at the TS–SS junction.…”

Section: Introductionmentioning

confidence: 99%

Multiphysics coupling numerical simulation of flow‐diverting stents in the treatment of patients with pulsatile tinnitus

Liu

Sun

et al. 2021

Numer Methods Biomed Eng

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Patients with pulsatile tinnitus (PT) have unstable treatment effects after resurfacing surgery. Flow‐diverting stents (FDS) are proposed as a potential method for the treatment of PT, but the therapeutic effect is not clear. This study aimed to investigate the efficacy of FDS in the treatment of patients with PT induced by sigmoid sinus diverticulum (SSD) and sigmoid sinus wall dehiscence (SSWD). In addition, we aimed to explore the treatment mechanism of PT. Transient‐state multiphysics coupling numerical simulation method based on computed tomography angiography of five patients was used to clarify the biomechanical and acoustic states before and after FDS placement. FDS was placed to prevent the blood flow from impacting the vessel wall in the SSD and SSWD areas. Low blood flow velocity (<0.0391 m/s), high relative residence time (>10 Pa−1), and low wall shear stress of SSD might lead to thrombosis after FDS placement. The average pressure on the SSWD area of each patient decreased by 13.77%, 18.82%, 29.23%, 19.03%, and 11.20%. The average displacement of the vessel wall on the SSWD area showed acute pulsation and decreased by 15.29%, 14.64%, 30.22%, 41.03%, and 21.28%. The average sound pressure level at the tympanum decreased by 14.01%, 9.33%, 17.66%, 18.88%, and 25.18%, respectively. In brief, FDS was placed to avoid blood flow impacting vessels and reduce the vibration of vessels in the short term, thereby attenuating the degree of PT. The long‐term prognosis was that the SSWD area was blocked after SSD thrombosis. Therefore, FDS might be an effective method for the treatment of PT induced by SSD and SSWD. This study would provide a theoretical basis for the treatment of PT and an exploration of FDS design in the treatment of PT.

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Multiphysics coupling study on the effect of blood flow pulsation in patients with pulsatile tinnitus

Sun

et al. 2021

Biocybernetics and Biomedical Engineering

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Computational fluid dynamics study of the effect of transverse sinus stenosis on the blood flow pattern in the ipsilateral superior curve of the sigmoid sinus

Cited by 18 publications

References 24 publications

Study on the correlation between hemodynamic status of the transverse sinus-sigmoid sinus and the clinical efficacy of sigmoid sinus wall reconstruction

Study on the correlation between hemodynamic status of the transverse sinus-sigmoid sinus and the clinical efficacy of sigmoid sinus wall reconstruction

Multiphysics coupling numerical simulation of flow‐diverting stents in the treatment of patients with pulsatile tinnitus

Multiphysics coupling study on the effect of blood flow pulsation in patients with pulsatile tinnitus

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