Department of Otolaryngology, College of Medicine and Medical Center, National Cheng Kung University, Tainan, Taiwan.
Ear Nose Throat J. 2024 Mar;103(3):NP145-NP147. doi: 10.1177/01455613211043683. Epub 2021 Sep 24.
Pulsatile tinnitus (PT) caused by a high-riding dehiscence jugular bulb (HDJB) is a rare but treatable otology disease. There are several managements include transcatheter endovascular coil embolization, transvenous stent-assisted coil embolization, or resurfacing the dehiscent bony wall of high jugular bulb under the use of microscope. Among those options, surgical resurfacing of HDJB might be an effective and safe choice with less destruction. However, previous studies approached middle ear cavity via microscope can only provide a lateral, indirect view, while resurfacing the vessel through a transcanal endoscopic ear surgery (TEES) approach may give surgeon a direct and easy way to manage HDJB. In this report, we presented a case of 40-year-old woman with HDJB and shared our clinical consideration and reasoning of the surgical management of PT via a transtympanic approach by TEES rather than a transmastoid approach.
由高位颈静脉球窗（HDJB）引起的搏动性耳鸣（PT）是一种罕见但可治疗的耳科学疾病。有几种治疗方法，包括经导管血管内线圈栓塞、经静脉支架辅助线圈栓塞，或在显微镜下重新覆盖高位颈静脉球的骨窗。在这些选择中，手术重新覆盖 HDJB 可能是一种有效且安全的选择，破坏较小。然而，之前通过显微镜进入中耳腔的研究只能提供一个侧面的间接视图，而通过经耳道内镜耳外科（TEES）方法重新覆盖血管可能为外科医生提供一种直接且易于管理 HDJB 的方法。在本报告中，我们介绍了一位 40 岁女性的 HDJB 病例，并分享了我们通过 TEES 经鼓室入路而不是经乳突入路治疗 PT 的手术管理的临床考虑和推理。
