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Published in: Surgical and Radiologic Anatomy 7/2020

01-07-2020 | Magnetic Resonance Imaging | Original Article

Positional relationship between the external acoustic meatus and sigmoid sinus: an MRI study

Authors: Satoshi Tsutsumi, Hideo Ono, Hisato Ishii

Published in: Surgical and Radiologic Anatomy | Issue 7/2020

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Abstract

Purpose

There is no study exploring the positional relationship between the external acoustic meatus (EAM) and the sigmoid sinus (SS) in detail. The present study aimed to characterize the relationship using contrast magnetic resonance imaging (MRI).

Methods

In total, 85 patients with an intact EAM, SS, and surrounding structures underwent thin-sliced, contrast MRI. Imaging data were transferred to a workstation for analysis.

Results

In all patients, the EAM and SS were well depicted on both the sagittal and axial images. The relationships and distances between the EAM and SS, in addition to the shape of cross sections of the EAM, were highly variable with left–right asymmetry. The positional relationships between the EAM and the anterior edge of the SS were classified into superior, intervening, and inferior types. The intervening type was the most predominant, accounting for 85%. The shortest distance between the posterior wall of the EAM and the anterior margin of the SS was 12.3 ± 3.9 mm on the right side and 13.0 ± 2.9 mm on the left. In three women, the distance was less than 5 mm on the right side.

Conclusions

The positional relationship between the EAM and SS is highly variable and inconsistent. These structures may be adjacent, especially on the right side, and presurgical contrast MRI should be included when planning surgeries around the EAM.
Literature
1.
go back to reference Chawla A, Ezhil Bosco JI, Lim TC, Shenoy JN, Krishnan V (2015) Computed tomography features of external auditory canal cholesteatoma: a pictorial review. Curr Probl Diagn Radiol 44:511–516CrossRef Chawla A, Ezhil Bosco JI, Lim TC, Shenoy JN, Krishnan V (2015) Computed tomography features of external auditory canal cholesteatoma: a pictorial review. Curr Probl Diagn Radiol 44:511–516CrossRef
2.
go back to reference Cisneros JC, Lopes PT, Bento RF, Tsuji RK (2017) Sinus pericranii, petrosquamosal sinus and extracranial sigmoid sinus: anatomical variations to consider during a retroauricular approach. Auris Nasus Larynx 44:359–364CrossRef Cisneros JC, Lopes PT, Bento RF, Tsuji RK (2017) Sinus pericranii, petrosquamosal sinus and extracranial sigmoid sinus: anatomical variations to consider during a retroauricular approach. Auris Nasus Larynx 44:359–364CrossRef
3.
go back to reference Çam OH, Karataş M (2015) A life threatening pitfall in ear surgery: extracranial sigmoid sinus. J Craniofac Surg 26:e619–e620CrossRef Çam OH, Karataş M (2015) A life threatening pitfall in ear surgery: extracranial sigmoid sinus. J Craniofac Surg 26:e619–e620CrossRef
4.
go back to reference Deguine C, Pulec JL (1997) Attic cholesteatoma with erosion of the superior bony canal wall. Ear Nose Throat 76:848CrossRef Deguine C, Pulec JL (1997) Attic cholesteatoma with erosion of the superior bony canal wall. Ear Nose Throat 76:848CrossRef
5.
go back to reference Gangopadhyay K, McArthur PD, Larsson SG (1996) Unusual anterior course of the sigmoid sinus: report of a case and review of the literature. J Laryngol Otol 110:984–986CrossRef Gangopadhyay K, McArthur PD, Larsson SG (1996) Unusual anterior course of the sigmoid sinus: report of a case and review of the literature. J Laryngol Otol 110:984–986CrossRef
6.
go back to reference Ichijo H, Hosokawa M, Shinkawa H (1996) The relationship between mastoid pneumatization and the position of the sigmoid sinus. Eur Arch Otorhinolaryngol 253:421–424CrossRef Ichijo H, Hosokawa M, Shinkawa H (1996) The relationship between mastoid pneumatization and the position of the sigmoid sinus. Eur Arch Otorhinolaryngol 253:421–424CrossRef
7.
go back to reference Kennel CE, Puricelli MD, Rivera AL (2019) Surgically-relevant anatomy of the external auditory canal bulge and scutum. Otol Neurotol 40:e1037–e1044CrossRef Kennel CE, Puricelli MD, Rivera AL (2019) Surgically-relevant anatomy of the external auditory canal bulge and scutum. Otol Neurotol 40:e1037–e1044CrossRef
8.
go back to reference Lansley JA, Tucker W, Eriksen MR, Riordan-Eva P, Connor SEJ (2017) Sigmoid sinus diverticulum, dehiscence, and venous sinus stenosis: potential causes of pulsatile tinnitus in patients with idiopathic intracranial hypertension? AJNR Am J Neuroradiol 38:1783–1788CrossRef Lansley JA, Tucker W, Eriksen MR, Riordan-Eva P, Connor SEJ (2017) Sigmoid sinus diverticulum, dehiscence, and venous sinus stenosis: potential causes of pulsatile tinnitus in patients with idiopathic intracranial hypertension? AJNR Am J Neuroradiol 38:1783–1788CrossRef
9.
go back to reference McComick MW, Bartels HG, Rodriguez A, Johnson JE, Janjua RM (2016) Anatomical variations of the transverse-sigmoid sinus junction: implications for endovascular treatment of idiopathic intracranial hypertension. Anat Rec (Hoboken) 299:1037–1042CrossRef McComick MW, Bartels HG, Rodriguez A, Johnson JE, Janjua RM (2016) Anatomical variations of the transverse-sigmoid sinus junction: implications for endovascular treatment of idiopathic intracranial hypertension. Anat Rec (Hoboken) 299:1037–1042CrossRef
10.
go back to reference McDonald TJ, Facer GW, Clark JL (1986) Surgical treatment of the external auditory canal. Laryngoscope 96:830–833CrossRef McDonald TJ, Facer GW, Clark JL (1986) Surgical treatment of the external auditory canal. Laryngoscope 96:830–833CrossRef
11.
go back to reference Raso JL, Gusmão SN (2011) A new landmark for finding the sigmoid sinus in suboccipital craniotomies. Neurosurg 68:1–6CrossRef Raso JL, Gusmão SN (2011) A new landmark for finding the sigmoid sinus in suboccipital craniotomies. Neurosurg 68:1–6CrossRef
12.
go back to reference Ribas GC, Rhoton AL Jr, Cruz OR, Peace D (2005) Suboccipital burr holes and craniectomies. Neurosurg Focus 19:E1CrossRef Ribas GC, Rhoton AL Jr, Cruz OR, Peace D (2005) Suboccipital burr holes and craniectomies. Neurosurg Focus 19:E1CrossRef
13.
go back to reference Roche J, Warner D (1996) Arachnoid granulations in the transverse and sigmoid sinuses: CT, MR, and MR angiographic appearance of a normal anatomic variation. AJNR Am J Neuroradiol 17:677–683PubMed Roche J, Warner D (1996) Arachnoid granulations in the transverse and sigmoid sinuses: CT, MR, and MR angiographic appearance of a normal anatomic variation. AJNR Am J Neuroradiol 17:677–683PubMed
14.
go back to reference Roland PS, Meyerhoff W, Mickey B (1991) Management of the external auditory canal in skull base surgery. Skull Base Surg 1:39–42CrossRef Roland PS, Meyerhoff W, Mickey B (1991) Management of the external auditory canal in skull base surgery. Skull Base Surg 1:39–42CrossRef
15.
go back to reference Roychaudhuri BK, Roychowdhury A, Ghosh S, Nandy S (2011) Study on the anatomical variations of the posterosuperior bony overhang of external auditory canal. Indian J Otolaryngol Head Neck Surg 63:136–140CrossRef Roychaudhuri BK, Roychowdhury A, Ghosh S, Nandy S (2011) Study on the anatomical variations of the posterosuperior bony overhang of external auditory canal. Indian J Otolaryngol Head Neck Surg 63:136–140CrossRef
16.
go back to reference Sirikçi A, Bayazit YA, Kervancioğlu S, Ozer E, Kanlikama M, Bayram M (2004) Assessment of mastoid air cell size versus sigmoid sinus variables with a tomography-assisted digital image processing program and morphometry. Surg Radiol Anat 26:145–148CrossRef Sirikçi A, Bayazit YA, Kervancioğlu S, Ozer E, Kanlikama M, Bayram M (2004) Assessment of mastoid air cell size versus sigmoid sinus variables with a tomography-assisted digital image processing program and morphometry. Surg Radiol Anat 26:145–148CrossRef
17.
go back to reference Tsutsumi S, Ono H, Yasumoto Y (2017) The mastoid emissary vein: an anatomic study with magnetic resonance imaging. Surg Radiol Anat 39:351–356CrossRef Tsutsumi S, Ono H, Yasumoto Y (2017) The mastoid emissary vein: an anatomic study with magnetic resonance imaging. Surg Radiol Anat 39:351–356CrossRef
18.
go back to reference Ugur HC, Dogan I, Kahilogullari G, Al-Beyati ES, Ozdemir M, Kayaci S, Comert A (2013) New practical landmarks to determine sigmoid sinus free zones for suboccipital approaches: an anatomical study. J Craniofac Surg 24:1815–1818CrossRef Ugur HC, Dogan I, Kahilogullari G, Al-Beyati ES, Ozdemir M, Kayaci S, Comert A (2013) New practical landmarks to determine sigmoid sinus free zones for suboccipital approaches: an anatomical study. J Craniofac Surg 24:1815–1818CrossRef
19.
go back to reference Ulug T, Basaran B, Minareci O, Aydin K (2004) An unusual complication of stapes surgery: profuse bleeding from the anteriorly located sigmoid sinus. Eur Arch Otorhinolaryngol 261:397–399CrossRef Ulug T, Basaran B, Minareci O, Aydin K (2004) An unusual complication of stapes surgery: profuse bleeding from the anteriorly located sigmoid sinus. Eur Arch Otorhinolaryngol 261:397–399CrossRef
20.
go back to reference Van Osch K, Allen D, Gare B, Hudson TJ, Ladak H, Agrawal SK (2019) Morphological analysis of sigmoid sinus anatomy: clinical applications to neurological surgery. J Otolaryngol Head Neck Surg 48:2CrossRef Van Osch K, Allen D, Gare B, Hudson TJ, Ladak H, Agrawal SK (2019) Morphological analysis of sigmoid sinus anatomy: clinical applications to neurological surgery. J Otolaryngol Head Neck Surg 48:2CrossRef
21.
go back to reference Virapongse C, Sarwar M, Sasaki C, Kier EL (1983) High resolution computed tomography of the osseous external auditory canal: 1 Normal anatomy. J Comput Assist Tomogr 7:486–492CrossRef Virapongse C, Sarwar M, Sasaki C, Kier EL (1983) High resolution computed tomography of the osseous external auditory canal: 1 Normal anatomy. J Comput Assist Tomogr 7:486–492CrossRef
22.
go back to reference Woods A, Lagravère MO (2018) Three-dimensional changes of the auditory canal in a three-year period during adolescence using CBCTs. Int J Dent 2018:5463753CrossRef Woods A, Lagravère MO (2018) Three-dimensional changes of the auditory canal in a three-year period during adolescence using CBCTs. Int J Dent 2018:5463753CrossRef
23.
go back to reference Wright CG (1997) Development of the human external ear. J Am Acad Audiol 8:379–382PubMed Wright CG (1997) Development of the human external ear. J Am Acad Audiol 8:379–382PubMed
Metadata
Title
Positional relationship between the external acoustic meatus and sigmoid sinus: an MRI study
Authors
Satoshi Tsutsumi
Hideo Ono
Hisato Ishii
Publication date
01-07-2020
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2020
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-020-02469-9

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