Hemodynamic study of the therapeutic effects of the different degrees of sigmoid sinus diverticulum reconstruction on patients

Suqin Huang; Xiaoshuai Li; Xiaofei Xue; Xiaoyu Qiu; Zhenxia Mu; Minrui Fu; Bin Gao; Pengfei Zhao; Zhenchang Wang

doi:10.1016/j.medengphy.2020.10.008

Hemodynamic study of the therapeutic effects of the different degrees of sigmoid sinus diverticulum reconstruction on patients

Med Eng Phys. 2020 Dec:86:8-15. doi: 10.1016/j.medengphy.2020.10.008. Epub 2020 Oct 9.

Authors

Suqin Huang¹, Xiaoshuai Li², Xiaofei Xue¹, Xiaoyu Qiu², Zhenxia Mu¹, Minrui Fu¹, Bin Gao³, Pengfei Zhao⁴, Zhenchang Wang⁵

Affiliations

¹ Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China.
² Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
³ Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China. Electronic address: gaobin@bjut.edu.cn.
⁴ Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: zhaopengf05@163.com.
⁵ Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: cjr.wzhch@vip.163.com.

PMID: 33261738
DOI: 10.1016/j.medengphy.2020.10.008

Abstract

Sigmoid sinus diverticulum (SSD) is a common pathophysiology of pulsatile tinnitus (PT) and mainly treated by SSD reconstruction surgery. The degree of reconstruction is an important indicator of SSD reconstruction surgery, but its impact on the effect of SSD reconstruction is unclear. This study aimed to clarify the effect of the degree of SSD reconstruction on diverticulum reconstruction surgical treatment. One patient-specific case (control subject) was reconstructed based on the computed tomography angiography (CTA) images of patients with PT. The SSD reconstruction degree was used as a new index in this study. And the case of 30% (case 1), 60% (case 2), and 100% (case 3) of the diverticulum reconstruction degree of control subject were constructed. Transient-state computational fluid dynamics was performed. Wall pressure distribution, wall average pressure (P_avg) of SSD, flow pattern (velocity streamlines and velocity vector), wall shear stress (WSS) and averaged WSS (WSS_avg) were calculated and used in evaluating the hemodynamic differences among the DRD cases. Results demonstrated that change in SSD pressure was not linear with increase in DRD. The DRD that reached 60% of the original diverticulum was effective. At the peak point of the inlet boundary condition (T1 = 0.22s), the P_avg of SSD had a nonlinear change (control subject, 126.967 Pa vs. case 1, 126.274 Pa vs. case 2, 106.897 Pa vs. case 3, 94.116 Pa). Flow vorticity decreased gradually, and the smoothness of the streamlines increased with DRD. WSS_avg slightly changed with increasing DRD. The high-speed flow blood hit the diverticulum entrance and then swirled to hit the area of the sigmoid sinus wall abnormal. It was concluded that flow patterns related to PT differ with DRD. In diverticulum reconstruction surgery, there is a threshold value, and only when the DRD exceeds this value (60% or 70% or 80%), it will have a noticeable effect. In this study, DRD should at least reach 60% of the original diverticulum. When DRD is insufficient, hemodynamic change in the diverticulum is small, and the PT may have remained. SSD may be caused by high-speed blood flow.

Keywords: Computational fluid dynamics; Hemodynamics; Pulsatile tinnitus; SSD reconstruction degree; Sigmoid sinus diverticulum.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cranial Sinuses
Diverticulum* / diagnostic imaging
Diverticulum* / surgery
Hemodynamics
Humans
Hydrodynamics
Tinnitus*