• DemirBerin TuğtağBTDepartment of Anatomy, Faculty of Medicine, Ankara Medipol University, Ankara, Turkey. Electronic address: berin.tugtag@ankaramedipol.edu.tr., Davut Akduman, Burak Bilecenoğlu, and Kaan Orhan.
• Department of Anatomy, Faculty of Medicine, Ankara Medipol University, Ankara, Turkey. Electronic address: berin.tugtag@ankaramedipol.edu.tr.
• World Neurosurg. 2024 Mar 1; 183: e127e135e127-e135.

ObjectiveIn this study, we aimed to analyze the relationship of the sigmoid sinus (SS) with the external auditory canal, facial nerve, and mastoid cells from an anatomic point of view, to define the position of the SS during transmastoid, translabyrinthine, retrosigmoid (lateral suboccipital) approaches, in tympanomastoidectomy and posterior cranial fossa surgery.MethodsIn this study, the morphologic structures associated with the sigmoid sinus were evaluated in cone beam computed tomography images taken between 2015 and 2022. The images of 68 men and 106 women, aged 18-65 years, obtained from the archive of Ankara University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology were analyzed.ResultsThe most common SS pattern was type II, with a rate of 60.8% (n = 209); the second was type III, with 20.6% (n = 71); and the least common was type I, with 18.6% (n = 64). Although the distance between the horizontal line passing through the external auditory canal and facial nerve and the anterior contour of the SS was highest in type I (right, 7.26 ± 1.62; left, 7.44 ± 0.97), it was lowest in type III (right, 4.40 ± 1.50; left, 4.84 ± 1.16) (P < 0.05).ConclusionsThis study highlights the importance of the SS position in surgery, with special reference to otologic, neurotologic, and posterior cranial fossa surgery. To avoid intraoperative complications, each patient should be evaluated preoperatively by appropriate radiologic methods.Copyright © 2023 Elsevier Inc. All rights reserved.

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