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To report two cases of transmastoid clipping of a sigmoid sinus diverticulum.
Methods
Two patients with pulsatile tinnitus resulting from a sigmoid sinus diverticulum underwent clipping at the diverticulum neck using intra-operative Doppler ultrasonography.
Results
At six months’ follow up, both patients reported complete resolution of pulsatile tinnitus with no complications.
Conclusion
Transmastoid clipping of a sigmoid sinus diverticulum can be a safe and effective method of managing pulsatile tinnitus resulting from a sigmoid sinus diverticulum.
To report a case of sigmoid sinus dehiscence presenting with pulsatile tinnitus and treated successfully with resurfacing.
Case report:
This patient presented with pulsatile tinnitus due to sigmoid sinus dehiscence. This was successfully treated using only soft tissue resurfacing.
Conclusion:
Sigmoid sinus dehiscence is a rare but treatable cause of pulsatile tinnitus. It can occur in the absence of a diverticulum, and is not necessarily limited to the transverse sigmoid junction. When resurfacing, care must be taken not to significantly alter the extraluminal diameter of the sigmoid in a dominant sinus, as this raises the risk of post-operative hydrocephalus.
Sigmoid sinus thrombosis (SST) usually follows acute as well as chronic otitis media with coalescent mastoiditis. A singular case of noncoalescent mastoiditis complicated with thrombosis of deep cerebral sinuses occurring in a young child is presented. A genetic thrombophilic disorder (prothrombin G20210A allele mutation) was identified as the predisposing factor for this unusual complication. Particular emphasis is placed on the course of the disease, which showed regression only after surgical exploration and additional anticoagulant therapy. We conclude that a thorough and early assessment of coagulation factors should always be performed, especially in the population at risk, in order to rule out unusual aetiologies of these rare but still life-threatening pathological processes.
Radical neck dissection is one of the commonest procedures performed in any unit dealing with head and neck surgery. Intracranial complications following this procedure are uncommon. Transverse sinus thrombosis and venous infarction of the brain following unilateral radical neck dissection have not been reported in the literature. We present a case in which this complication occurred following an uneventful radical neck dissection.
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