Other very rare causes include a persistent stapedial artery or a paraganglioma. Similar sound transmission can occur if the passage of blood through the sigmoid sinus (a large vein that travels very close to the ear) is turbulent, either because of a diverticulum (a bit that sticks out) or because the bony wall of the sinus is rough or too thin. Here, a higher pressure of the fluid inside the head leads to pressure on the thin sheets of bone between the brain and the ear, causing the bone to become thin and in some cases for tiny holes to appear. This condition is usually thought of as affecting overweight young and middle-aged women, though it can occur in people of any age and gender. This happens in a condition called Benign Intracranial Hypertension. If the bony barriers between the blood vessels and the ear are thinned, then the sound can be transmitted more easily and picked up by the ear.
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