Evaluation of sigmoid sinus hemodynamics through four-dimensional flow magnetic resonance imaging in pulsatile tinnitus patients caused by sigmoid sinus wall dehiscence coexisting with idiopathic intracranial hypertension

To evaluate hemodynamics in the sigmoid sinus of sigmoid sinus wall dehiscence (SSWD)-pulsatile tinnitus (PT) patients with idiopathic intracranial hypertension using four-dimensional (4D) flow MRI.

4D flow MRI provides hemodynamic detail in a specific pulsatile tinnitus subtype (sigmoid sinus wall dehiscence plus idiopathic intracranial hypertension) that may aid surgical planning, but the study design limits generalizability — no immediate protocol change for most clinics.

Combining 4D flow MRI with conventional imaging could refine pre-operative assessment for a treatable structural cause of pulsatile tinnitus, potentially reducing unnecessary procedures.

1. 014D flow MRI was used to measure blood-flow dynamics in the sigmoid sinus of pulsatile tinnitus patients.
2. 02Target population had a rare dual pathology: sigmoid sinus wall dehiscence plus idiopathic intracranial hypertension.
3. 03The technique may visualize turbulent or aberrant hemodynamics not visible on standard MRI or CT.
4. 04Findings could guide surgical decision-making for this specific pulsatile tinnitus subtype.
5. 05Advanced imaging access limits immediate translation to community audiology or ENT settings.

PMID

42228107

DOI

10.1007/s00405-026-10321-w.

Journal

European Archives of Oto-Rhino-Laryngology

Publication type

research_article

Evidence level

4

Population

Patients with pulsatile tinnitus caused by sigmoid sinus wall dehiscence coexisting with idiopathic intracranial hypertension

Intervention

4D flow magnetic resonance imaging of the sigmoid sinus