Prevalence of Petrosquamosal Sinus and Its Clinical Significance: Radiologic Study and Meta-analysis

OBJECTIVE: The petrosquamosal sinus (PSS) is clinically important as it represents a potential hemorrhagic hazard during neurosurgical procedures. This double-approach radiologic study and meta-analysis aimed to assess the imaging characteristics of the PSS on computed tomography (CT) and systematically analyze its prevalence to improve imaging accuracy and assist in neurosurgical management. METHODS: The retrospective radiologic study included CT scans of 388 patients aged 18 years or older. All patients with any visible intracranial pathologies or history of head trauma were excluded. To identify articles eligible for inclusion in our meta-analysis, an extensive search was conducted through PubMed, Embase, ScienceDirect, Web of Science, and CNKI. Data extracted included investigative method, prevalence of the PSS among subjects, ethnicity, gender, side, laterality, and mean diameter. The extracted data were pooled into a meta-analysis with a random-effects model. RESULTS: The radiologic study showed that the PSS was visualized in 25.5% of the sides examined, that it was slightly more common among females (27.5%) than males (23.8%) and on the left (21.7%) than the right (29.4%). Its mean diameter was 1.14 +/- 0.58 mm. The meta-analysis revealed that the overall prevalence of the PSS in the population is 11.1%, that it is more common in females (27.4%) than males (17.6%), and that a unilateral PSS is more common (78.2%) than a bilateral one (21.8%). CONCLUSIONS: As a PSS is present in about one tenth of the population, it is important to consider the possibility that it is present when undertaking neurosurgical procedures and to assess preoperative CT scans to avoid complications.