Humans ; Cranial Sinuses/surgery* ; Intracranial Hypertension/etiology*

OBJECTIVETo discuss the diagnosis and management of venous original pulsatile tinnitus associated with sigmoid sinus.

METHODSA retrospective study was conducted on 12 patients who were diagnosed with venous original pulsatile tinnitus associated with sigmoid sinus, and treated with sigmoid sinus constriction surgery. The diagnostic evidences for venous original pulsatile tinnitus associated with sigmoid sinus were re-evaluated, the pulsatile tinnitus improvements and MRV study results before and after surgeries associated with sigmoid sinus were compared.

RESULTSEleven patients got relief of tinnitus within three months after the surgeries, while one patient had no relief. There were ten patients underwent MRV study, the cross-sectional area of the sigmoid sinus in the healthy side was about two times in the tinnitus side. Constriction sigmoid sinus was performed on the twelve patients. The cross-sectional area of the sigmoid sinus of relieved tinnitus patients were compressed by forty-six percent to eighty-three percent. None of the cases complained of any serious complications.

CONCLUSIONSSigmoid sinus constriction is an available therapy for pulsatile tinnitus at present. More cases and longer follow-up are necessary to evaluate its treatment effect accurately.

Cranial Sinuses ; surgery ; Diverticulum ; complications ; surgery ; Humans ; Male ; Middle Aged ; Tinnitus ; etiology ; surgery

Humans ; Facial Nerve/surgery* ; Endolymphatic Sac/surgery* ; Cranial Sinuses ; Postoperative Complications ; Neoplasms

Cranial Sinuses ; surgery ; Humans ; Infant ; Otorhinolaryngologic Surgical Procedures ; instrumentation ; Surgical Instruments

It is extremely dangerous to treat the posterior third of the superior sagittal sinus (PTSSS) surgically, since it is usually not completely ligated. In this report, the authors described the case of a 27-year-old man with a ruptured and defective PTSSS caused by an open depressed skull fracture, which was treated by ligation of the PTSSS and the patient achieved a positive recovery. The patient's occiput was hit by a height-limiting rod and was in a mild coma. A CT scan showed an open depressed skull fracture overlying the PTSSS and a diffuse brain swelling. He underwent emergency surgery. When the skull fragments were removed, a 4 cm segment of the superior sagittal sinus (SSS) and the adjacent dura mater were removed together with bone fragments. Haemorrhage occurred and blood pressure dropped. We completed the operation by ligating the severed ends of the fractured sagittal sinus. One month after the operation, apart from visual field defects, he recovered well. In our opinion, in primary hospitals, when patients with severely injured PTSSS cannot sustain a long-time and complicated operation, e.g., the bypass using venous graft, and face life-threatening conditions, ligation of the PTSSS is another option, which may unexpectedly achieve good results.
Adult ; Cranial Sinuses ; Humans ; Male ; Skull Fracture, Depressed/surgery* ; Superior Sagittal Sinus/surgery* ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the anatomical structures of cranial nerves in the cerebellopontine angle region to offer anatomical data for clinical operation. METHOD: A total of 52 adult cadaveric heads fixed in 10% formalin were used for this study. After cutting cerebellum and meningeal between transverse and sigmoid sinus, simulate operating method of retrosigmoid approach to observe the cranial nerves. RESULT: External diameter and length of left V, VII, VIII, IX cranial nerves are (2.54 +/- 0.84) mm and (6.79 +/- 2.51) mm, (1.18 +/- 0.31) mm and (9.89 +/- 2.66) mm, (2.17 +/- 0.52) mm and (9.92 +/- 2.61) mm, (0.77 +/- 0.24) mm and (10.34 +/- 3.12) mm respectively. External diameter and length of right V , VII, VIII, IX cranial nerves are (2.52 +/- 0.86) mm and (6.91 +/- 2.66) mm, (1.14 +/- 0.31) mm and (10 +/- 2.96) mm, (2.13 +/- 0.63) m and (10.09 +/- 2.93) mm, (0.790.29) mm and (10.17 +/- 3.06) mm. intermedius nerve locate between facial nerve and acoustic nerve, external diameter of intermedius nerve is (0.47 +/- 0.91) mm (left) and (0.37 +/- 0.07) mm (right). Length of vagal nerve is (10.44 +/- 2.57) mm (left), (9.91 +/- 2.91) mm (right), rootlets of f vagal nerve is 6.37 +/- 2.26 (left) and 6.33 +/- 2.38 (right). external diameter of accessory nerve is (0.76 +/- 0.16) mm (left) and (0.81 +/- 0.19) mm (right). CONCLUSION This study provide anatomical data for retrosigmoid approach in the cerebellopontine angle region.
Adult ; Cerebellopontine Angle ; anatomy & histology ; Cranial Nerves ; anatomy & histology ; Cranial Sinuses ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; Glossopharyngeal Nerve ; anatomy & histology ; Humans ; Vestibulocochlear Nerve ; anatomy & histology

The authors present the experience of ligation of transverse or sigmoid sinus in the surgical removal of petroclival meningiomas. We reviewed the medical records and venograms of 14 patients with petroclival meningiomas, in whom the intraoperative ligation of transverse or sigmoid sinus had been done at our hospital between 1986 and 1999. All patients passed the intraoperative test clamping of the sinus. The drainage pattern of confluence of Herophili was classified into four types: type A, confluence and equal drainage on both transverse sinuses; type B, confluence and non-dominant transverse sinus on the tumor side; type C, confluence and dominant transverse sinus on the tumor side; and type D, unilateral transverse sinus only. Among the 14 cases, four cases were in type A, five cases in type B, and two were type C. There was no evidence of brain swelling after intraoperative test clamping of the sinus for more than 30 min. None of the patients experienced postoperative complications related with sinus ligation. Our observation suggests that the transverse or sigmoid sinus ligation is tolerable to patients sinus. who show the drainage patterns of type A, type B, and type C, if the test clamping proves to be safe.
Adolescent ; Adult ; Cerebrovascular Circulation ; Cranial Sinuses/pathology/*surgery ; Female ; Humans ; Ligation ; Male ; Meningioma/pathology/*surgery ; Middle Aged ; *Neurosurgical Procedures ; Phlebography ; Postoperative Complications

BACKGROUND AND OBJECTIVES: Endoscopic paranasal sinus surgery is effective for the treatment of paranasal sinus lesion and reduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. But, some studies showed that there was a risk of invasive management and major complications occurring in 0.5% to 1% of all procedures. The aim of this study was to assess the usefulness and effectiveness of image-guided endoscopic surgery in reducing the complication and treating the disease suitably. SUBJECTS AND METHOD: The image-guided paranasal sinus surgery was performed in 12 patients from 2000 to 2005 who had difficulty in endoscopic surgery for the diagnosis and treatment of the inaccessible location such as skull base, sphenoid and clivus, infratemporal fossa etc. and the uncertain lesion such as severe distorted lesion due to previous sinus operation, congenitally underdeveloped anatomic lesion, nearby vital organ-lesion and submucosal lesion in our experiences. We retrospectively reviewed radiologic evaluations and medical records in our patients. RESULTS: We included 6 oncogenic lesions such as craniopharyngioma, chordoma in clivus and sphenoid sinus, 5 infectious lesions such as invasive aspergillosis and 1 cystic lesion. The accuracy we could achieve varied between 0.9 and 2.0 mm. CSF rhinorrhea occurred in 2 cases after management. But, only one case was not only related to image-guided surgery but also resolved spontaneously. CONCLUSION: Image-guided endoscopic surgery is a safe and effective tool in paranasal sinus and skull base lesion for maximizing surgical results and limiting complications.
Aspergillosis ; Chordoma ; Cranial Fossa, Posterior ; Craniopharyngioma ; Diagnosis ; Endoscopy ; Humans ; Medical Records ; Paranasal Sinuses ; Retrospective Studies ; Skull Base* ; Skull* ; Sphenoid Sinus ; Surgery, Computer-Assisted*