Hemodynamics study on the relationship between the sigmoid sinus wall dehiscence and the blood flow pattern of the transverse sinus and sigmoid sinus junction

Mu, Zhenxia; Li, Xiaoshuai; Zhao, Dawei; Qiu, Xiaoyu; Dai, Chihang; Meng, Xuxu; Huang, Suqin; Gao, Bin; Lv, Han; Li, Shu; Zhao, Peng; Liu, Youjun; Wang, Zhenchang; Yw, Chang

doi:10.1016/j.jbiomech.2022.111022

Cited by 9 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is notable that the hydroacoustic sound can also be detected using an electro-stethoscope, in which case the thickness and hardness of the 3D-printed materials may render collecting a lower amplitude ( Valluru et al, 2020 ). The elbow-like sinus regions, such as the transverse-sigmoid sinus junction and jugular bulb, are typical locations where vortical flow structures emanate ( Mu et al, 2022 ). The current CFD method demonstrated that the flow amplitude at the transverse sinus, transverse-sigmoid junction and jugular bulb was higher than that of the vascular segments without sharp turns, and these elbow-like regions exhibited a high-pressure gradient and/or flow velocity.…”

Section: Discussionmentioning

confidence: 99%

Influence of sigmoid plate and dura mater on vascular wall displacement, vibroacoustic/hydroacoustic sources characteristics, and frequency-loudness assessments of venous pulsatile tinnitus: A coupled-computational fluid dynamics study combining transcanal recording investigation

Wang

Hsieh

Xü

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Investigations of pulsatile tinnitus (PT) caused by sigmoid sinus wall anomalies (SSWAs) using computational fluid dynamics (CFD) have recently increased in prevalence. However, accurate modeling of anatomical structures regarding sigmoid plate dehiscence and acoustic sources of PT remains lacking. This study incorporates coupled CFD techniques, micro-computed tomography, and scanning electron microscope to reveal the vibroacoustic and hydroacoustic sources and displacement characteristics of the transverse-sigmoid sinus system. Furthermore, the in vivo transcanal-recording technique combined with ipsilateral internal jugular vein compression was implemented to cross-reference the captured acoustic profile of PT with the calculated results. In this study, the transient state coupled CFD technique was used to calculate the vibroacoustic and hydroacoustic sources. The dehiscent sigmoid plate and periosteal dura mater were then reconstructed. The displacement characteristics and acoustic results were analyzed. The displacement of the vascular wall underneath the dehiscent area was 9.6 times larger than that of the sigmoid plate and 3,617 times smaller than that of the vascular wall without the overlying osseous structures. The peak amplitude of flow-induced vibroacoustic noise was 119.3 dB at 20.2 Hz measured at the transverse sinus. Within the observed 20–1,000 Hz frequency range, the largest peak amplitude of hydroacoustic noise was 80.0 dB at 20.2 Hz located at the jugular bulb region. The simulated results conformed with the in vivo acoustic profile which the major frequency of PT falls within 1,000 Hz. In conclusion, 1) the sigmoid plate and dura mater greatly impact vascular wall displacement, which should not be overlooked in CFD simulations. 2) By incorporating the transcanal recording technique with IJV compression test, the primary frequency of PT was found fluctuating below 1,000 Hz, which matches the frequency component simulated by the current CFD technique; amplitude-wise, however, the peak amplitude of in vivo pulse-synchronous somatosound measures approximately 10 dB, which is comparatively lesser than the CFD results and the subjectively perceived loudness of PT. Thus, the transmission pathway, intramastoid acoustic impedance/amplification effect, and the perceptive threshold of PT require further investigations to minimize the incidence of surgical failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Influence of sigmoid plate and dura mater on vascular wall displacement, vibroacoustic/hydroacoustic sources characteristics, and frequency-loudness assessments of venous pulsatile tinnitus: A coupled-computational fluid dynamics study combining transcanal recording investigation

Wang

Hsieh

Xü

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

show abstract

“…A high degree of TSS can further exacerbate the trans -stenotic pressure gradient of the transverse sinus, which impairs intracranial pressure that may be less relevant to the production of PT ( Zhao et al, 2021a , b ). Additionally, studies have suggested that high wall pressure and wall shear stress induced by TSS may underpin the development of SSWAs ( Hsieh and Wang, 2020 ; Mu et al, 2022 ), and the recent discovery of bone remodeling of the dehiscent sigmoid plate after excluding hemodynamic pathologies via endoluminal stenting surgery supports this postulation ( Qiu et al, 2021a ).…”

Section: Introductionmentioning

confidence: 99%

“…SSWAs refer to sigmoid sinus wall dehiscence and sigmoid sinus diverticulum. Without the bolster of the overlying sigmoid plate, a diverticulum forms when the sigmoid sinus vascular wall protrudes into the mastoid air cells and/or the mastoid cortex ( Eisenman et al, 2018 ; Mu et al, 2022 ). Given the increase in flow velocity, sinus flow carries higher kinetic energy in the transverse–sigmoid junction region after releasing from transverse sinus stenosis (TSS; Hewes et al, 2020 ; Zhao et al, 2021a ).…”

Section: Introductionmentioning

confidence: 99%

Retroauricular/Transcranial Color-Coded Doppler Ultrasound Approach in Junction With Ipsilateral Neck Compression on Real-Time Hydroacoustic Variation of Venous Pulsatile Tinnitus

Xiuli

Hsieh

Wang

et al. 2022

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Alterations in dural venous sinus hemodynamics have recently been suggested as the major contributing factors in venous pulsatile tinnitus (PT). Nevertheless, little is known about the association between real-time alterations in hemodynamics and the subjective perception of venous PT. This study aimed to investigate the hydroacoustic correlations among diverticular vortices, mainstream sinus flow, and PT using various Doppler ultrasound techniques. Nineteen venous PT patients with protrusive diverticulum were recruited. The mainstream sinus and diverticular hemodynamics before and after ipsilateral internal jugular vein (IJV) compression were investigated using an innovative retroauricular color-coded Doppler (RCCD) method to examine the correlation between the disappearance of PT and hemodynamic alterations. To reveal the hydroacoustic characteristics of disparate segments of venous return, a computational fluid dynamics (CFD) technique combined with the transcranial color-coded Doppler method was performed. When the ipsilateral IJV was compressed, PT disappeared, as the mean velocity of mainstream sinus flow and diverticular vortex decreased by 51.2 and 50.6%, respectively. The vortex inside the diverticulum persisted in 18 of 19 subjects. The CFD simulation showed that the flow amplitude generated inside the transverse–sigmoid sinus was segmental, and the largest flow amplitude difference was 20.5 dB. The difference in flow amplitude between the mainstream sinus flow and the diverticular flow was less than 1 dB. In conclusion, the sensation of PT is closely associated with the flow of kinetic energy rather than the formation of a vortex, whereby the amplitude of PT is correlated to the magnitude of the flow velocity and pressure gradient. Additionally, the range of velocity reduction revealed by the RCCD method may serve as a presurgical individual baseline curative marker that may potentially optimize the surgical outcomes.

show abstract

“…According to the clinical literature, the SSWD region is primarily localized on the anterior lateral of the transverse sinus (TS)-SS junction [ 6 ], involving the upper or middle segment of the SS vessel and presenting as a long strip (65.9%) [ 7 ]. Patients with SSWD are frequently afflicted with SS diverticulum (SSD), TS stenosis, and high-riding jugular bulbs.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research demonstrated that the place where the blood flow impinges on venous vessels in the TS–SS junction coincides with the SSWD region [ 6 ]. We proposed that the impingement of the blood flow on the venous vessel promotes an increase in the wall pressure, which may be correlated to the production of SSWD [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Multiphysics Interaction Analysis of the Therapeutic Effects of the Sigmoid Sinus Wall Reconstruction in Patients with Venous Pulsatile Tinnitus

Zhuang

Zhao

et al. 2023

Bioengineering

Self Cite

View full text Add to dashboard Cite

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 10−3 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.

show abstract

Hemodynamics study on the relationship between the sigmoid sinus wall dehiscence and the blood flow pattern of the transverse sinus and sigmoid sinus junction

Cited by 9 publications

References 27 publications

Influence of sigmoid plate and dura mater on vascular wall displacement, vibroacoustic/hydroacoustic sources characteristics, and frequency-loudness assessments of venous pulsatile tinnitus: A coupled-computational fluid dynamics study combining transcanal recording investigation

Influence of sigmoid plate and dura mater on vascular wall displacement, vibroacoustic/hydroacoustic sources characteristics, and frequency-loudness assessments of venous pulsatile tinnitus: A coupled-computational fluid dynamics study combining transcanal recording investigation

Retroauricular/Transcranial Color-Coded Doppler Ultrasound Approach in Junction With Ipsilateral Neck Compression on Real-Time Hydroacoustic Variation of Venous Pulsatile Tinnitus

Multiphysics Interaction Analysis of the Therapeutic Effects of the Sigmoid Sinus Wall Reconstruction in Patients with Venous Pulsatile Tinnitus

Contact Info

Product

Resources

About