Imaging Prevalence of Sigmoid Sinus Dehiscence among Patients with and without Pulsatile Tinnitus

Abstract

Objectives:

1) Appreciate the incidence of sigmoid sinus diverticulum/dehiscence (SSDD) among patients with pulsatile tinnitus (PT) and its prevalence in patients undergoing high resolution temporal bone computed tomography (HRCT) for other reasons. 2) Understand comorbidities associated with SSDD.

Methods:

Retrospective chart review of patients undergoing temporal bone imaging between January 2003 and November 2012 at a tertiary care university medical center. Two groups were evaluated for evidence of SSDD. The first (“PT”) group included all patients whose radiology report mentioned a clinical history of PT (n = 38 symptomatic ears in 30 patients). The second group (“non-PT”) included all patients undergoing temporal bone HRCT between November 2011 and November 2012 (n = 323 ears in 171 patients). Primary outcome measure was the radiographic presence of SSDD. Variables including age, gender, body mass index (BMI), and systemic hypertension were analyzed by two-tailed Fisher’s exact tests.

Results:

Within the PT group, SSDD was identified in 24% of ears (9/38) and 23% of patients (7/30); all SSDD patients were female (P = .029). There were no differences in mean age, BMI, or presence of hypertension between those with and those without SSDD. In the non-PT group, SSDD was identified in 2 (both female) of 171 patients (1.2%; 0.6% of ears). The difference in SSDD prevalence between the two groups was significant (P = .0001).

Conclusions:

The prevalence of SSDD in patients with PT was 24%. The prevalence of SSDD among all patients undergoing HRCT in one year was 1.2%. In our study, SSDD affected females exclusively.