title: Sigmoid sinus cortical plate dehiscence induces pulsatile tinnitus through amplifying sigmoid sinus venous sound.
abstract: Sigmoid sinus cortical plate dehiscence (SSCPD) is common in pulsatile tinnitus (PT) patients, and is treated through SSCPD resurfacing surgery in clinic, but the bio-mechanism is not clear as so far. This study aimed to clarify the bio-mechanism of PT sensation induced by SSCPD, and quantify the relationship of cortical plate (CP) thickness and PT sensation intensity. It was hypothesized that SSCPD would induce PT through significantly amplifying sigmoid sinus (SS) venous sound in this study. Finite element (FE) analysis based on radiology data of typical patient was used to verify this hypothesis, and was validated with clinical reports. In cases with different CP thickness, FE simulations of SS venous sound generation and propagation procedure were performed, involving SS venous flow field, vibration response of tissue overlying dehiscence area (including SS vessel wall and CP) and sound propagation in temporal bone air cells. It was shown in results that SS venous sound at tympanic membrane was 56.9dB in SSCPD case and -45.2dB in intact CP case, and was inaudible in all thin CP cases. It was concluded that SSCPD would directly induce PT through significantly amplifying SS venous sound, and thin CP would not be the only pathophysiology of PT. This conclusion would provide a theoretical basis for the design of SSCPD resurfacing surgery for PT patients with SSCPD or thin CP.
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 37# Xueyuan Road, Haidian District, Beijing 100191, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Tian
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 37# Xueyuan Road, Haidian District, Beijing 100191, China.
authors.forename: Lizhen
authors.initials: L
authors.lastname: Wang
authors.affiliation: National Research Center for Rehabilitation Technical Aids, Beijing 100176, China.
authors.forename: Jiemeng
authors.initials: J
authors.lastname: Yang
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 37# Xueyuan Road, Haidian District, Beijing 100191, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Mao
authors.affiliation: Department of Radiology, Beijing Tongren Hospital, Capital Medical University, 1# Dongjiaominxiang, Dongcheng district, Beijing 100730, China. Electronic address: lzhtrhos@163.com.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, 37# Xueyuan Road, Haidian District, Beijing 100191, China; National Research Center for Rehabilitation Technical Aids, Beijing 100176, China. Electronic address: yubofan@buaa.edu.cn.
authors.forename: Yubo
authors.initials: Y
authors.lastname: Fan
mesh_terms: D000328:Adult; D003392:Cranial Sinuses / Q000503:physiopathology*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D013016:Sound; D014012:Tinnitus / Q000503:physiopathology*; D014432:Tympanic Membrane / Q000503:physiopathology
keywords: Cortical plate dehiscence; Finite element analysis; Pulsatile tinnitus; Sigmoid sinus; Venous sound