Positional relationship between the external acoustic meatus and sigmoid sinus: an MRI study

Purpose There is no study exploring the positional relationship between the external acoustic meatus (EAM) and the sigmoid sinus (SS) in detail. The present study aimed to characterize the relationship using contrast magnetic resonance imaging (MRI). Methods In total, 85 patients with an intact EAM, SS, and surrounding structures underwent thin-sliced, contrast MRI. Imaging data were transferred to a workstation for analysis. Results In all patients, the EAM and SS were well depicted on both the sagittal and axial images. The relationships and distances between the EAM and SS, in addition to the shape of cross sections of the EAM, were highly variable with left-right asymmetry. The positional relationships between the EAM and the anterior edge of the SS were classified into superior, intervening, and inferior types. The intervening type was the most predominant, accounting for 85%. The shortest distance between the posterior wall of the EAM and the anterior margin of the SS was 12.3 +/- 3.9 mm on the right side and 13.0 +/- 2.9 mm on the left. In three women, the distance was less than 5 mm on the right side. Conclusions The positional relationship between the EAM and SS is highly variable and inconsistent. These structures may be adjacent, especially on the right side, and presurgical contrast MRI should be included when planning surgeries around the EAM.