Morphological remodeling of the repaired sigmoid sinus bone wall in patients with pulsatile tinnitus after successful surgical reconstruction: an ultra-high-resolution CT study.

Abstract

Background: Sigmoid sinus wall reconstruction (SSWR) is an effective treatment for pulsatile tinnitus (PT). However, follow-up postoperative imaging manifestations have not been extensively reported.

Purpose: To evaluate the morphological changes in patients with PT after successful SSWR using ultra-high-resolution computed tomography (U-HRCT).

Material and methods: Data were retrospectively analyzed from 10 patients with PT who underwent successful SSWR primarily with autologous bone powder. U-HRCT scans were performed within 3 days of surgery and repeated 6 months later. The integrity, relative density, extent, and shape of the repaired wall were analyzed. The chi-square test was used to compare the categorical variables and the Phi (φ) coefficient was used to represent the magnitude of the correlation.

Results: Among the 10 patients with PT, 1 (10%) achieved complete coverage of the defect with the residual bone, 8 (80%) had partial coverage, and 1 (10%) showed complete separation. A gap between the repaired wall and residual bone in the initial U-HRCT was linked to incomplete defect coverage in the subsequent U-HRCT scan (P < 0.001, φ = 0.903). The repaired wall shrank from the periphery to the center and the density increased. The repaired wall compressed into the sigmoid sinus retracts over time, reshaping into a naturally curved sigmoid sinus sulcus.

Conclusion: Morphological remodeling is a typical characteristic of the repaired sigmoid sinus wall in patients with PT. Short-term incomplete repair may imply incomplete coverage of the defect in the future, but this is not correlated with recurrence.