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血管成形术和支架置入术治疗硬脑膜静脉窦狭窄引起的顽固性搏动性耳鸣:病例系列报告。

Angioplasty and stenting for intractable pulsatile tinnitus caused by dural venous sinus stenosis: a case series report.

机构信息

*Department of Neurosurgery, Chinese PLA General Hospital, Beijing, People's Republic of China; and †Tinnitus Clinic, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.

出版信息

Otol Neurotol. 2014 Feb;35(2):366-70. doi: 10.1097/MAO.0b013e3182990d52.

Abstract

OBJECTIVE

Pulsatile tinnitus caused by dural venous sinus (DVS) stenosis is a newly identified form of tinnitus. Its persistent nature can severely affect patients' sleep and quality of life, leading to depression in severe cases. The aim of this report is to investigate the efficacy and safety of angioplasty and stenting in treating this form of tinnitus.

STUDY DESIGN

Retrospective review.

SETTING

Chinese PLA General Hospital.

METHODS

Clinical data of 46 cases of pulsatile tinnitus caused by DVS stenosis treated between December 2009 and October 2012 using angioplasty and stenting were reviewed. Diagnosis of DVS abnormality was confirmed in all cases using digital subtraction angiography (DSA). Among these cases, stenosis was located in the transverse-sigmoid sinuses junction area ipsilateral to tinnitus in 44 cases and on both sides in the remaining 2 cases. Stenosis was treated with angioplasty and stenting in all cases.

RESULTS

Pulsatile tinnitus disappeared immediately after the procedure in all 46 cases. There was no procedure-related complication. During the 2 to 36 months' follow-up, there was no recurrence.

CONCLUSION

These results indicate that DVS stenosis is the cause of pulsatile tinnitus in these cases and that angioplasty and stenting are an effective and safe treatment for intractable pulsatile tinnitus caused by DVS stenosis.

摘要

目的

硬脑膜静脉窦(DVS)狭窄引起的搏动性耳鸣是一种新确定的耳鸣形式。其持续性可严重影响患者的睡眠和生活质量,严重者可导致抑郁。本报告旨在探讨血管成形术和支架置入治疗这种形式的耳鸣的疗效和安全性。

研究设计

回顾性研究。

地点

中国人民解放军总医院。

方法

回顾性分析 2009 年 12 月至 2012 年 10 月采用血管成形术和支架置入治疗的 46 例 DVS 狭窄引起的搏动性耳鸣患者的临床资料。所有病例均采用数字减影血管造影(DSA)确诊 DVS 异常。其中,44 例耳鸣同侧横窦-乙状窦交界处狭窄,2 例双侧狭窄。所有病例均采用血管成形术和支架置入治疗狭窄。

结果

46 例患者术后搏动性耳鸣立即消失,无手术相关并发症。2 至 36 个月随访无复发。

结论

这些结果表明,DVS 狭窄是这些患者搏动性耳鸣的原因,血管成形术和支架置入是治疗 DVS 狭窄引起的难治性搏动性耳鸣的有效、安全的方法。

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