1187. Prevalence of Petrosquamosal Sinus: A Meta-Analysis and Radiological Study of Anatomical Characteristics

Authors: Bendik Skinningsrud; Dominik Taterra; Justyna Rybus, MD; Magdalena Stachura, MD; Przemysław Pękala, MD, PhD; Jakub Pękala; R. Shane Tubbs; Krzysztof Tomaszewski (Krakow, Poland)

Introduction: Petrosquamosal sinus (PSS), an embryonic emissary vein of the temporal bone, remains poorly defined due to its anatomical variation. When unrecognized, major posterior fossa emissary veins such as PSS can cause surgical complications such as severe hemorrhage, thrombosis, air embolism, retrograde spread of infection or tumors, and fatal increases in intracranial pressure. This radiological study and meta-analysis aimed to assess the imaging characteristics of the PSS on CT and systematically analyze its prevalence and anatomical characteristics to improve imaging accuracy and assist in neurosurgical management. Methods: To identify articles eligible for inclusion in our meta-analysis, an extensive search was conducted through the major electronic databases. Data extracted included study modality, prevalence, ethnicity, gender, side, laterality, and mean diameter. The extracted data was pooled into a meta-analysis with a random-effects model. Our radiological study included CT scans of 388 patients at least 18 years of age. Results: Our meta-analysis showed that the overall prevalence of the PSS in the population was 11.1%, it was more common in women (27.4%) than men (17.6%), and a unilateral PSS was more common (78.2%) than a bilateral one (21.8%). In our radiological study, the PSS was visualized in 25.5% of the sides examined, it was slightly more common among women (27.5%) than men (23.8%), and on the right side (29.4%) than the left side (21.7%). Its mean diameter was 1.14±0.58mm. Conclusion: As a PSS is present in about one-tenth of the population, if a tubular structure is traced in the petrous and mastoid region by a preoperative CT, neurosurgeons and neuroradiologists should be aware of the possibility of it being a PSS and obtain additional information using other techniques such as brain CTA to preclude iatrogenic errors.