Petrosquamosal sinus in the temporal bone as a cause of pulsatile tinnitus: a radiological detection

Incidence of Vascular Anomalies and Variants Associated with Unilateral Venous Pulsatile Tinnitus in 242 Patients Based on Dual-phase Contrast-enhanced Computed Tomography

“…[ 2 27 ] The vascular anomalies and variants detected in this study are all factors potentially capable of changing normal perfusion (such as a dehiscent sigmoid plate, lateral sinus stenosis, sigmoid sinus diverticulum or jugular bulb diverticulum, large emissary vein, petrosquamosal sinus, and sinus thrombosis) or sound transmission (such as a dehiscent sigmoid plate and dehiscent jugular bulb). [ 3 4 11 12 15 28 ] Our results support the notion that venous PT is closely related to these vascular anomalies and variants.…”

“…We aimed to determine whether venous PT patients showed multiple vascular anomalies or variants on the PT side, which has rarely been assessed previously. [ 4 12 15 18 24 ] To that end, we detected with more than one vascular anomaly or variant on the symptomatic side in 170 patients (70.2%) using CT, while only 58 patients (24.0%, 58/242) were diagnosed with a single lesion. Signorelli et al .…”

“…The vascular anomalies and variants on symptomatic and asymptomatic sides were analyzed and evaluated retrospectively. These evaluated vascular anomalies and variants were diagnosed on the following previously described criteria [ Figure 1 ]: (1) High jugular bulb, the jugular bulb extended above the inferior border of the round window;[ 1 ] (2) dehiscent jugular bulb or dehiscent sigmoid plate, the incomplete thin bone around the jugular bulb or the sigmoid sinus;[ 4 10 ] (3) jugular bulb diverticulum, prominent protrusion or an irregular out-pouching of jugular bulb that was clearly distinguished from a smooth ellipsoidal form;[ 22 ] (4) sigmoid sinus diverticulum, a diverticulum entered into the mastoid bone;[ 9 ] (5) lateral sinus stenosis, the L/S ratio (L = the largest area of the vein; S = the smallest area of the vein) was >4.75;[ 11 ] (6) large emissary vein, diameter of the emissary veins was >3.5 mm;[ 12 ] (7) petrosquamosal sinus, embryologic emissary vein running along the petrosquamosal Fissure;[ 15 ] and (8) sinus thrombosis, signs of thrombosis were noted, including the empty δ-sign or an irregular filling defect. [ 23 ] These anomalies and variants were analyzed in each patient and summed.…”

“…Thus far, previous studies on the incidence of these anomalies and variants of venous PT have notable limitations; they used small sample sizes and did not include several recently described venous PT anomalies, such as a dehiscent sigmoid plate and petrosquamosal sinus. [ 3 4 5 8 10 11 12 13 14 15 16 ] In addition, a more effective technique (dual-phase contrast-enhanced computed tomography [DP-CECT]) capable of detailing the vessels and temporal bones simultaneously has been gaining popularity for PT diagnosis, but it has not been investigated previously. [ 3 17 18 ] Therefore, additional research evaluating the incidence of vascular anomalies and variants in venous PT is needed.…”

Aberrant sylvian vein: A newly described cause of pulsatile tinnitus

“…Avascular causes include glomus tumors, pneumocephalus, otosclerosis, Paget’s disease, histiocytosis X, myoclonus, and dehiscent semicircular canals. 3 – 5 , 9 – 12 PT usually seriously affects the patient’s quality of life. Some patients even commit suicide because the noise is unbearable.…”