Department of Otorhinolaryngology-Head & Neck Surgery, University of Maryland School of Medicine, Frenkil Building, 16 S. Eutaw St. Suite 500, Baltimore, MD 21201, United States of America.
Department of Ophthalmology, University of Maryland School of Medicine, 419 West Redwood St. Suite 420, Baltimore, MD 21201, United States of America.
Am J Otolaryngol. 2020 Nov-Dec;41(6):102675. doi: 10.1016/j.amjoto.2020.102675. Epub 2020 Aug 13.
Pulse synchronous tinnitus (PT) is common in patients with idiopathic intracranial hypertension (IIH) and in those with sigmoid sinus wall abnormalities (SSWAs). Although patients with SSWAs and IIH share many clinical features, the incidence of SSWAs in patients with IIH and its relationship to PT in this cohort is less well established. The purpose of this study is to assess the incidence of SSWAs in patients with IIH and PT, and to determine if there is an association between SSWAs and PT in this population.
Prospective computed tomography (CT) study of adults with IIH. Subjective PT was correlated with presence or absence of SSWAs on CT.
22 subjects were enrolled and 14 subsequently underwent CT. The incidence of SSWAs was significantly higher in subjects with PT than without (70% vs. 0%, p = 0.02). Mean age, BMI and opening pressures did not differ between those with and without SSWAs or PT.
There is a high incidence of SSWAs in subjects with IIH and PT. These findings support an association between SSWAs and PT, and implicate SSWAs as a possible cause of, or contributing factor to, PT in patients with IIH. Patients with IIH and PT that does not resolve with reducing intracranial pressure should undergo diagnostic CT and consider treatment of a SSWA if present.
脉冲同步性耳鸣（PT）在特发性颅内高压（IIH）患者和乙状窦壁异常（SSWA）患者中很常见。虽然 SSWA 患者和 IIH 患者有许多共同的临床特征，但 IIH 患者中 SSWA 的发生率及其与该队列中 PT 的关系尚未得到充分确立。本研究旨在评估 IIH 和 PT 患者中 SSWA 的发生率，并确定该人群中 SSWA 与 PT 是否存在关联。
对 IIH 成人进行前瞻性计算机断层扫描（CT）研究。主观 PT 与 CT 上 SSWA 的存在与否相关。
共纳入 22 名受试者，其中 14 名随后进行了 CT 检查。有 PT 的受试者 SSWA 的发生率明显高于没有 PT 的受试者（70%比 0%，p=0.02）。有 SSWA 和无 SSWA 或 PT 的受试者的平均年龄、BMI 和开放压力无差异。
IIH 和 PT 患者的 SSWA 发生率很高。这些发现支持 SSWA 与 PT 之间存在关联，并暗示 SSWA 可能是 IIH 患者 PT 的原因或促成因素。对于 IIH 和 PT 患者，如果颅内压降低后 PT 仍未缓解，应进行诊断性 CT 检查，并考虑治疗 SSWA（如果存在）。
