Goderie Thadé Pieter Marie, Alkhateeb Waiel Hussain Fadhlallah, Smit Conrad Frits, Hensen Erik Frans
*Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center Amsterdam †Department of Otolaryngology/Head and Neck Surgery, Slotervaart Medical Center, Amsterdam ‡Department of Otolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Otol Neurotol. 2017 Jul;38(6):788-791. doi: 10.1097/MAO.0000000000001466.
To evaluate the outcome and per- and postoperative complications of the surgical management of patients with a persistent stapedial artery (PSA).
A systemic literature search for reports on patients treated for pulsatile tinnitus and/or conductive hearing loss caused by a PSA was conducted of the PubMed and Embase databases using the terms "stapedial" and "artery." Inclusion criteria were adequate description of the intervention and pre- and postoperative signs and symptoms. In addition, one case of a PSA, treated at VU University Medical Center Amsterdam, The Netherlands, was included in this series.
Middle ear surgery consisting of stapedotomy or stapedectomy, and/or transection of the PSA.
Pre- and postoperative hearing levels, pre- and postoperative pulsatile tinnitus, and per- and postoperative complications.
Seventeen patients and 18 operated ears were evaluated (16 patients described in 14 articles and our case). Twelve out of 14 ears in which a stapedotomy or stapedectomy was initiated experienced improvement in hearing. In four cases pulsatile tinnitus was described pre- and postoperatively. In all four, pulsatile tinnitus subsided after transection of the PSA. Peroperative bleeding from the PSA was described in four patients, which could be controlled during the procedure. No significant postoperative sequelae were reported.
In case of a PSA, improvement of conductive hearing loss is best achieved by stapes surgery, while pulsatile tinnitus is effectively treated with transection of the PSA. To date no long-term postoperative complications have been reported.
评估持续性镫骨动脉（PSA）患者手术治疗的结果以及围手术期和术后并发症。
使用“镫骨”和“动脉”等术语，在PubMed和Embase数据库中系统检索关于因PSA导致搏动性耳鸣和/或传导性听力损失患者治疗情况的报告。纳入标准为对干预措施以及术前和术后体征及症状有充分描述。此外，本系列纳入了荷兰阿姆斯特丹VU大学医学中心治疗的1例PSA病例。
中耳手术，包括镫骨足板切除术或镫骨切除术，和/或切断PSA。
术前和术后听力水平、术前和术后搏动性耳鸣以及围手术期和术后并发症。
评估了17例患者和18只手术耳（14篇文章中描述的16例患者以及我们的病例）。14只开始进行镫骨足板切除术或镫骨切除术的耳朵中，有12只听力得到改善。4例患者术前和术后均有搏动性耳鸣描述。在所有4例中，切断PSA后搏动性耳鸣消失。4例患者术中出现PSA出血，术中可控制。未报告明显的术后后遗症。
对于PSA患者，镫骨手术能最好地改善传导性听力损失，而切断PSA可有效治疗搏动性耳鸣。迄今为止，尚未报告长期术后并发症。
