因硬脑膜动静脉狭窄引起的持续性搏动性耳鸣：血管内静脉窦支架置入术是答案吗？
Relentless pulsatile tinnitus secondary to dural sinovenous stenosis: is endovascular sinus stenting the answer?
机构信息
Department of Radiology, Faculty of Medicine, Ain Shams University, Abbassiya, 11566, Cairo, Egypt.
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Zagazig, Sharqiya, Egypt.
出版信息
Clin Radiol. 2021 Jul;76(7):526-531. doi: 10.1016/j.crad.2021.02.022. Epub 2021 Mar 21.
AIM
To assess the efficacy of endovascular venous sinus stenting (EVSS) in treating pulsatile tinnitus (PT) caused by dural venous sinus stenosis (DVSS), and to determine whether it is an adequate remedy in cases with concurrent venous anomalies.
MATERIALS AND METHODS
Seventeen patients (13 female and four male) with PT due to DVSS were treated using EVSS. The trans-stenotic pressure gradient (PG) was measured before and after stenting. The effect of stenting on the tinnitus was evaluated by questioning the patients at day 0, and at 3, 6, and 9 months after stenting.
RESULTS
Except for one patient who continued to complain of PT, all of the patients, including two with concomitant sinus diverticula, described complete resolution of the tinnitus immediately following stenting. The post-stenting PG was significantly lower than the pre-stenting PG (p<0.0001). No procedure related complications occurred and no recurrence was recorded during the follow-up period.
CONCLUSION
EVSS is a safe and successful treatment for PT due to DVSS even in cases with coexistent sinus diverticula.
目的
评估血管内静脉窦支架置入术（EVSS）治疗硬脑膜静脉窦狭窄（DVSS）引起的搏动性耳鸣（PT）的疗效，并确定其在伴有静脉异常的情况下是否为一种适当的治疗方法。
材料与方法
对 17 例（13 例女性和 4 例男性）因 DVSS 导致 PT 的患者进行 EVSS 治疗。支架置入前后测量跨狭窄段压力梯度（PG）。支架置入后 0、3、6 和 9 个月通过询问患者评估支架对耳鸣的影响。
结果
除 1 例患者持续抱怨 PT 外，所有患者（包括 2 例伴有窦憩室）均立即完全缓解耳鸣。支架置入后的 PG 明显低于支架置入前的 PG（p<0.0001）。在随访期间未发生与手术相关的并发症，也未记录到复发。
结论
EVSS 是治疗 DVSS 引起的 PT 的一种安全且有效的方法，即使在伴有窦憩室的情况下也是如此。
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