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Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study
Introduction Sigmoid sinus (SS) variations have been classified variously in the literature. These classifications suffer from some form of shortcoming from a clinical point of view for their application. Objective We propose a clinically relevant classification of the SS in relation to the poster...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Publicações Ltda
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660287/ https://www.ncbi.nlm.nih.gov/pubmed/31360251 http://dx.doi.org/10.1055/s-0039-1688455 |
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author | Singh, Anup Irugu, David Victor Kumar Sikka, Kapil Verma, Hitesh Thakar, Alok |
author_facet | Singh, Anup Irugu, David Victor Kumar Sikka, Kapil Verma, Hitesh Thakar, Alok |
author_sort | Singh, Anup |
collection | PubMed |
description | Introduction Sigmoid sinus (SS) variations have been classified variously in the literature. These classifications suffer from some form of shortcoming from a clinical point of view for their application. Objective We propose a clinically relevant classification of the SS in relation to the posterior semicircular canal (PSCC) and to the exposure of the presigmoid dural plate. The positioning of the SS was analyzed with reference to the volume of the mastoid and to the level of mastoid pneumatization. Methods A total of 94 formalin-preserved human cadaveric temporal bones were microdissected to carry out a complete mastoidectomy. The SS, the presigmoid dural plate, and the PSCC were exposed, and the position of the former was analyzed in relation to the latter two in order to classify the position of the SS into three grades. Results Grade I had the best exposure of the presigmoid dura and of the PSCC, while grade III had the poorest exposure of the presigmoid dura and of the PSCC. Grade I SS was associated with good pneumatization and higher mastoid volumes compared with grades II and III. Conclusions The SS exhibits considerable anatomic variability. A favorable positioning of the SS is associated with a large mastoid volume and pneumatization. A careful preoperative study of the imaging may help in understanding the positioning of the SS and the safety of various transmastoid approaches. |
format | Online Article Text |
id | pubmed-6660287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Thieme Publicações Ltda |
record_format | MEDLINE/PubMed |
spelling | pubmed-66602872019-07-29 Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study Singh, Anup Irugu, David Victor Kumar Sikka, Kapil Verma, Hitesh Thakar, Alok Int Arch Otorhinolaryngol Introduction Sigmoid sinus (SS) variations have been classified variously in the literature. These classifications suffer from some form of shortcoming from a clinical point of view for their application. Objective We propose a clinically relevant classification of the SS in relation to the posterior semicircular canal (PSCC) and to the exposure of the presigmoid dural plate. The positioning of the SS was analyzed with reference to the volume of the mastoid and to the level of mastoid pneumatization. Methods A total of 94 formalin-preserved human cadaveric temporal bones were microdissected to carry out a complete mastoidectomy. The SS, the presigmoid dural plate, and the PSCC were exposed, and the position of the former was analyzed in relation to the latter two in order to classify the position of the SS into three grades. Results Grade I had the best exposure of the presigmoid dura and of the PSCC, while grade III had the poorest exposure of the presigmoid dura and of the PSCC. Grade I SS was associated with good pneumatization and higher mastoid volumes compared with grades II and III. Conclusions The SS exhibits considerable anatomic variability. A favorable positioning of the SS is associated with a large mastoid volume and pneumatization. A careful preoperative study of the imaging may help in understanding the positioning of the SS and the safety of various transmastoid approaches. Thieme Publicações Ltda 2019-07 2019-05-28 /pmc/articles/PMC6660287/ /pubmed/31360251 http://dx.doi.org/10.1055/s-0039-1688455 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Singh, Anup Irugu, David Victor Kumar Sikka, Kapil Verma, Hitesh Thakar, Alok Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title | Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title_full | Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title_fullStr | Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title_full_unstemmed | Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title_short | Study of Sigmoid Sinus Variations in the Temporal Bone by Micro Dissection and its Classification – A Cadaveric Study |
title_sort | study of sigmoid sinus variations in the temporal bone by micro dissection and its classification – a cadaveric study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660287/ https://www.ncbi.nlm.nih.gov/pubmed/31360251 http://dx.doi.org/10.1055/s-0039-1688455 |
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