Cassandro Ettore, Cassandro Claudia, Sequino Giuliano, Scarpa Alfonso, Petrolo Claudio, Chiarella Giuseppe
Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy.
ENT Department, San Giovanni Battista Hospital, University of Torino, 10124 Torino, Italy.
Case Rep Otolaryngol. 2015;2015:817313. doi: 10.1155/2015/817313. Epub 2015 Nov 26.
While pulsatile tinnitus (PT) and dural arteriovenous fistula (DAVF) are not rarely associated, the finding of a conductive hearing loss (CHL) in this clinical picture is unusual. Starting from a case of CHL and PT, diagnosed to be due to a DAVF, we analyzed relationship between intracranial vascular abnormalities and inner ear fluids. DAVF was treated with endovascular embolization. Following this, there was a dramatic recovery of PT and of CHL, confirming their cause-effect link with DAVF. We critically evaluated the papers reporting this association. This is the first case of CHL associated with PT and DAVF. We describe the most significant experiences and theories reported in literature, with a personal analysis about the possible relationship between vascular intracranial system and labyrinthine fluids. In conclusion, we believe that this association may be a challenge for otolaryngologists. So we suggest to consider the possibility of a DAVF or other AVMs when PT is associated with CHL, without alterations of tympanic membrane and middle ear tests.
虽然搏动性耳鸣（PT）与硬脑膜动静脉瘘（DAVF）常有关联，但在此临床症状中发现传导性听力损失（CHL）并不常见。从一例诊断为DAVF所致的CHL和PT病例出发，我们分析了颅内血管异常与内耳液体之间的关系。采用血管内栓塞治疗DAVF。此后，PT和CHL显著恢复，证实了它们与DAVF之间的因果关系。我们对报道这种关联的论文进行了批判性评估。这是首例与PT和DAVF相关的CHL病例。我们描述了文献中报道的最重要的经验和理论，并对颅内血管系统与迷路液体之间的可能关系进行了个人分析。总之，我们认为这种关联可能对耳鼻喉科医生构成挑战。因此，我们建议当PT与CHL相关且鼓膜和中耳检查无异常时，考虑DAVF或其他动静脉畸形（AVM）的可能性。
