Lee Seung-Jae, Lee Sang-Yeon, An Gwang-Seok, Lee Kyogu, Choi Byung-Yoon, Koo Ja-Won, Song Jae-Jin
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam 13620, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
J Clin Med. 2021 May 27;10(11):2348. doi: 10.3390/jcm10112348.
We reviewed the clinical characteristics and treatment outcomes of patients with glomus tympanicum tumors (GTTs) presenting with pulsatile tinnitus (PT). We explored whether transcanal sound recording-spectro-temporal analysis (TSR-STA) usefully evaluated changes in PT. The medical records of 13 patients who underwent surgical removal of GTTs were reviewed retrospectively. Two patients underwent preoperative endovascular embolization. Changes in PT, pre- and postoperative audiometry data, TSR-STA results, and clinical outcomes were evaluated. PT was the chief complaint in eight patients (61.5%) and resolved immediately after surgical intervention in all. Two patients exhibited ipsilateral, pseudo-low-frequency hearing loss (PLFHL); surgical GTT removal elicited postoperative improvements in the ipsilesional low-frequency hearing thresholds. Five patients underwent TSR-STA using previously described methods. TSR-STA revealed definite rise-and-fall patterns; surgical tumor removal abated this pattern in one patient, but, for the other four, the patterns did not change greatly post-intervention. Thus, GTT-related PT can be treated successfully (via surgical GTT removal) without complications. In selected cases, preoperative embolization reduces intraoperative hemorrhage. In PT patients with PLFHL, a detailed otoendoscopic examination of the middle ear is required to rule out a GTT. TSR-STA may usefully (and objectively) assess postoperative improvements in GTT-related PT.
我们回顾了以搏动性耳鸣（PT）为表现的鼓室球瘤（GTT）患者的临床特征和治疗结果。我们探讨了经耳道声音记录 - 频谱 - 时间分析（TSR - STA）是否有助于评估PT的变化。对13例行GTT手术切除患者的病历进行了回顾性分析。2例患者术前行血管内栓塞治疗。评估了PT的变化、术前和术后听力测定数据、TSR - STA结果及临床结局。PT是8例患者（61.5%）的主要诉求，所有患者在手术干预后PT立即缓解。2例患者出现同侧假性低频听力损失（PLFHL）；手术切除GTT后，患侧低频听力阈值术后有所改善。5例患者采用前述方法进行了TSR - STA。TSR - STA显示出明确的升降模式；手术切除肿瘤使1例患者的这种模式消失，但其他4例患者干预后模式变化不大。因此，GTT相关的PT可通过手术切除GTT成功治疗且无并发症。在某些病例中，术前栓塞可减少术中出血。对于伴有PLFHL的PT患者，需要进行详细的中耳耳内镜检查以排除GTT。TSR - STA可能有助于（且客观地）评估GTT相关PT术后的改善情况。
