Hemodynamic Changes in the Sigmoid Sinus of Patients With Pulsatile Tinnitus Induced by Sigmoid Sinus Wall Anomalies

Objective:This study is to investigate the hemodynamic changes of pulsatile tinnitus (PT) patients induced by sigmoid sinus wall anomalies (SSWA).Study Design:Prospective study.Setting:Tertiary referral university hospital.Patients:Fifteen unilateral PT patients with SSWA identified on computed tomography images and surgery and 15 age-, sex-, and body mass index-matched healthy volunteers underwent velocity-encoded, cine magnetic resonance imaging.Intervention:Hemodynamic data in sigmoid sinus were obtained from velocity-encoded, cine magnetic resonance imaging, and compared between PT patients and controls.Main Outcome Measures:Heart rate was recorded. Cross-sectional area (CSA), peak positive velocity (PPV), average positive flow volume per beat (APFV/beat), average flow volume per beat (AFV/beat), peak negative velocity (PNV), and average negative flow volume per beat (ANFV/beat) were measured. Average flow volume per minute (AFV/min), average positive flow volume per minute (APFV/min), average negative flow volume per minute (ANFV/min), average positive velocity (APV), average negative velocity (ANV), and regurgitation fraction (RF) were calculated.Results:APV at PT side of patients was 13.43.3cm/s, which was significantly slower than that at corresponding side of controls (15.8 +/- 2.6cm/s). PNV and RF at PT side of patients were 21.0 +/- 15.4cm/s and 2.4% respectively, which were significantly higher than those values at corresponding side of controls (both of them were 0). HR, CSA, PPV, APFV/beat, APFV/min, AFV/beat, AFV/min, ANV, ANFV/beat, and ANFV/min were 69.8 +/- 9.4beat/min, 48.4 +/- 17mm(2), 31.4 +/- 5.9cm/s, 5.4 +/- 1.8ml/beat, 373.9 +/- 117.7ml/min, 5.1 +/- 2.0ml/beat, 352.0 +/- 134.6ml/min, 2 (0-4.9) cm/s, 1 (0-2.7) ml/beat, and 4.1 (0-141.3) ml/min at PT side of patients, and 67.4 +/- 7.8beat/min, 38.2 +/- 18mm(2), 29.9 +/- 3.9cm/s, 5.3 +/- 2.0ml/beat, 350.3 +/- 125.3ml/min, 5.1 +/- 1.9ml/beat, 340.5 +/- 117.9ml/min, 0 (0-2.1) cm/s, 0 (0-0.8) ml/beat, and 0 (0-55.4) ml/min at corresponding side of controls. These hemodynamics were not significantly different between groups.Conclusion:APV, PNV, and RF changes take place in SSWA patients, which may be associated with the occurrence of PT and have the potential value to improve accurate etiological diagnosis and predict treatment success.