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. 2024 Jun 15;11(6):612.
doi: 10.3390/bioengineering11060612.

The Effect of Transverse Sinus Stenosis Caused by Arachnoid Granulation on Patients with Venous Pulsatile Tinnitus: A Multiphysics Interaction Simulation Investigation

Zhenxia Mu  1 , Pengfei Zhao  2 , Shifeng Yang  1 , Lihui Zhuang  1 , Heyu Ding  2 , Xiaoyu Qiu  2 , Bin Gao  3 , Youjun Liu  3 , Shusheng Gong  4 , Guopeng Wang  4 , Zhenchang Wang  2 , Ximing Wang  1
Affiliations

The Effect of Transverse Sinus Stenosis Caused by Arachnoid Granulation on Patients with Venous Pulsatile Tinnitus: A Multiphysics Interaction Simulation Investigation

Zhenxia Mu et al. Bioengineering (Basel). .

Abstract

This study aimed to investigate the effect of the transverse sinus (TS) stenosis (TSS) position caused by arachnoid granulation on patients with venous pulsatile tinnitus (VPT) and to further identify the types of TSS that are of therapeutic significance for patients. Multiphysics interaction models of six patients with moderate TSS caused by arachnoid granulation and virtual stent placement in TSS were reconstructed, including three patients with TSS located in the middle segment of the TS (group 1) and three patients with TTS in the middle and proximal involvement segment of the TS (group 2). The transient multiphysics interaction simulation method was applied to elucidate the differences in biomechanical and acoustic parameters between the two groups. The results revealed that the blood flow pattern at the TS and sigmoid sinus junction was significantly changed depending on the stenosis position. Preoperative patients had increased blood flow in the TSS region and TSS downstream where the blood flow impacted the vessel wall. In group 1, the postoperative blood flow pattern, average wall pressure, vessel wall vibration, and sound pressure level of the three patients were comparable to the preoperative state. However, the postoperative blood flow velocity decreased in group 2. The postoperative average wall pressure, vessel wall vibration, and sound pressure level of the three patients were significantly improved compared with the preoperative state. Intravascular intervention therapy should be considered for patients with moderate TSS caused by arachnoid granulations in the middle and proximal involvement segment of the TS. TSS might not be considered the cause of VPT symptoms in patients with moderate TSS caused by arachnoid granulation in the middle segment of the TS.

Keywords: arachnoid granulation; biomechanical; multiphysics interaction computation; pulsatile tinnitus; transverse sinus stenosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Geometry models. (a) Position of the temporal bone, venous vessel and TBAC. Taking patient 1–pre and patient 4–pre as examples: (b,c) position of the inlet, TS, TSS, SSD, SSWD, SS and outlet. (d) Position of the tympanum in TBAC. (e) Preoperative and postoperative venous vessel geometry models of each patient.
Figure 2
Figure 2
(a) Tetrahedral mesh of each domain model. (b) Boundary condition of the inlet section.
Figure 3
Figure 3
Preoperative and postoperative velocity vector at the maximum velocity moment of each patient.
Figure 4
Figure 4
Preoperative and postoperative wall pressure at the maximum velocity moment of each patient.
Figure 5
Figure 5
Preoperative and postoperative average wall pressure in the SSWD domain in the whole cardiac cycle of each patient.
Figure 6
Figure 6
Preoperative and postoperative average displacement of the venous vessel in the SSWD domain in the whole cardiac cycle of each patient.
See this image and copyright information in PMC

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