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脑静脉窦支架置入术和颈静脉球栓塞治疗搏动性耳鸣:一例报告。

Cerebral venous sinus stenting and jugular bulb embolization for pulsatile tinnitus: A case report.

作者信息

Xu Mengjiao, Dong Xiaobo, Zheng Can, Zheng Tao, Wang Gesheng

机构信息

Department of Brain Disease III, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Front Neurol. 2024 Feb 5;15:1330619. doi: 10.3389/fneur.2024.1330619. eCollection 2024.

Abstract

BACKGROUND

Pulsatile tinnitus (PT) is a rare form of tinnitus that aligns with the heartbeat. It is typically brought on by lesions with significant vascularity, which produce aberrant sound conduction and increase the risk of mental health issues and hearing loss. Venous PT is more prevalent than arterial PT. Open procedures or interventional procedures can be used to treat PT. We present here a case of PT caused by venous luminal stenosis combined with jugular bulb (JB) malformation, which was improved by stenting and JB embolization.

CASE PRESENTATION

A 59-year-old woman presented with long-term tinnitus consistent with heart rhythm and hearing loss, accompanied by anxiety, insomnia, and depression. The results of brain MRV, CT, and DSA showed stenosis of the right sigmoid sinus and high jugular bulb (JB) with dehiscence of the JB wall. The patient saw a significant improvement in PT symptoms following sigmoid sinus stenting and spring coil embolization of the high JB, following the diagnosis of PT. The patient had no PT recurrence for the course of the 31-month follow-up period.

CONCLUSION

In the present PT case, there was a simultaneous onset of the right sigmoid sinus stenosis and the high JB with the JB wall abnormalities. Sigmoid sinus stenting and spring coil embolization of high JB may be a treatment for the PT, but the prevention of post-stenting complications is still an issue that requires great attention and needs further study.

摘要

背景

搏动性耳鸣(PT)是一种罕见的耳鸣形式,与心跳同步。它通常由具有显著血管性的病变引起,这些病变会产生异常的声音传导,并增加心理健康问题和听力损失的风险。静脉性PT比动脉性PT更常见。开放手术或介入手术可用于治疗PT。我们在此报告一例由静脉腔狭窄合并颈静脉球(JB)畸形引起的PT病例,该病例通过支架置入和JB栓塞得到改善。

病例介绍

一名59岁女性出现与心律一致的长期耳鸣和听力损失,伴有焦虑、失眠和抑郁。脑部磁共振静脉血管造影(MRV)、计算机断层扫描(CT)和数字减影血管造影(DSA)结果显示右侧乙状窦狭窄和高位颈静脉球(JB),JB壁裂开。在诊断为PT后,患者在乙状窦支架置入和高位JB弹簧圈栓塞后,PT症状有显著改善。在31个月的随访期内,患者未出现PT复发。

结论

在本PT病例中,右侧乙状窦狭窄和高位JB同时出现,且JB壁异常。乙状窦支架置入和高位JB弹簧圈栓塞可能是治疗PT的一种方法,但支架置入后并发症的预防仍然是一个需要高度关注且有待进一步研究的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0726/10877715/f448af37bb41/fneur-15-1330619-g0001.jpg

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