Clinical Characteristics of Patients with Symptomatic Sigmoid Sinus Wall Anomalies: East vs West

Tuesday, October 14, 2025

8:24 AM - 8:30 AM EDT

Location: 239

Disclosure(s):

Christopher Z. Wen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Charlyn N. Gomez, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: US patients with pulsatile tinnitus (PT) due to sigmoid sinus wall abnormalities (SSWA) often have elevated body mass index (BMI), while East Asian patients with PT and SSWA appear not to. This study is the first to quantify and characterize BMI distributions between these patient populations and compare them to regional norms.

Methods: A systematic review of PubMed, Embase, and Scopus databases and a multi-institutional retrospective chart review of patients between 2007 and 2024 were performed focusing on patients with PT and SSWA. Pooled estimates of BMI (kg/m2) were derived and mean differences in patient BMI and other demographic and clinical findings were evaluated.

Results: Nine included studies comprised 165 (60%) Asian patients and 75 (31%) US patients. Most (91.3%) were female. Mean BMI for US patients was higher than for Asian patients (33.5 vs 23.8, p<.0001). The retrospective institutional review included 216 Asian patients and 112 American patients, also majority female. Average BMI of American patients was similarly higher than for Asian patients (33.6 vs 23.2, p<.0001).

In both datasets US patients had a higher mean BMI than the general population (∆BMI 3.3 for systematic review; ∆BMI 3.4 for retrospective review; p<.0001). There was no difference for the Asian population in the systematic review, but Asian patients had a lower mean BMI than the general population in the retrospective review (∆BMI 1.2, p<.0001). Asian patients were younger (42.0 vs 37.0 years, p=0.037) with lower rates of bilateral disease (0% vs 6.4%, p=0.016) for the meta-analysis but not within the retrospective review.

Conclusions: For PT patients with SSWA, BMI appears to be more of a defining characteristic for American patients than Asian patients. In conjunction with other factors, this may hint at two distinct subpopulations with different underlying etiologies of SSWA.

Presenting Author(s)

Christopher Z. Wen, MD

Resident, PGY-4
University of Maryland School of Medicine
Baltimore, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Charlyn N. Gomez, BS

Medical Student
University of Maryland School of Medicine
Silver Spring, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
YF

Yunting Fu, MLS

Health Sciences and Human Services Library, University of Maryland, Maryland, United States

Disclosure information not submitted.
JS

Jae-Jin Song, MD

Seoul National University Bundang Hospital, United States

Disclosure information not submitted.
YH

Yue-Lin Hsieh, MD

ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China (People's Republic)

Disclosure information not submitted.
WW

Wuqing Wang, MD

ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China (People's Republic)

Disclosure information not submitted.

Senior Author(s)

DE

David J. Eisenman, Professor

Vice-Chairman Dept. of Otorhinolaryngology- Head & Neck Surgery
University of Maryland School of Medicine
Baltimore, MD, United States

Disclosure information not submitted.