摘要
目的研究经乳突径路手术治疗乙状窦骨壁缺损引起的搏动性耳鸣的临床疗效。方法收集2014年3月—2018年6月诊断为乙状窦骨壁缺损引起的搏动性耳鸣并接受手术治疗的患者6例,其中男2例,女4例;年龄29~58岁,平均年龄38.5岁;左侧1例,右侧5例。术前行颞骨高分辨率CT(HRCT)检查,6例患者中均有不同程度乙状窦骨壁缺损,术前结合颅内血管数字减影血管造影(DSA)及颅内血管CT动静脉造影(CTA+CTV)等综合检查,排除引起搏动性耳鸣的其他疾患。全部患者均行乙状窦骨壁缺损修复术。结果6例患者术后均无眩晕、恶心、呕吐及脑脊液漏等并发症。随访6~29个月,6例患者搏动性耳鸣分级0级4例(痊愈)、1级1例(显效)、2级1例(有效),与术前比较差异均具有统计学意义(P<0.05),均无复发。结论通过手术治疗乙状窦骨壁缺损所致搏动性耳鸣的风险较小,疗效显著,是一种有效的治疗手段,值得临床推广应用。
Objective To explore the effect of surgical treatment of pulsatile tinnitus caused by sigmoid wall dehiscence.Methods A total of 6 patients with pulsatile tinnitus caused by sigmoid wall dehiscence undergoing surgical treatment were collected from March 2014 to June 2018.There were 2 males and 4 females.The average age is 38.5 years old.The lesion of 1 case was on the left side,and the lesions of 5 cases on the right side.High resolution CT scan of temporal bone was performed preoperatively.There were different degrees of sigmoid sinus wall dehiscence in all 6 patients.Preoperative comprehensive check such as DSA,CTA+CTV had ruled out other diseases can induce pulsatile tinnitus.All patients underwent with the operation of the reconstruction of sigmoid sinus.Results After surgery,tinnitus of all cases were significantly reduced or disappeared.All 6 patients had no postoperative complications,such as dizziness,nausea,vomiting,cerebrospinal fluid leakage.After follow up for 6~29 months,pulsatile tinnitus of 6 cases were not recurrence.The 6 patients with pulsating tinnitus were graded:4 cases of Grade 0(recovered),1 case of Grade 1(obvious effect),and 1 case of Grade 2(effective).The differences was statistically significant between the grades of pulsating tinnitus preoperation and those postoperation(P<0.05).Conclusions Surgical treatment for pulsatile tinnitus caused by sigmoid wall dehiscence was an effective treatment with less risk.It is worthy of clinical promotion and application.
作者
江远明
李春丽
何婷
邓刚
刘逸远
王璐璐
陈沛
JIANG Yuanming;LI Chunli;HE Ting;DENG Gang;LIU Yiyuan;WANG Lulu;CHEN Pei(Department of Otorhinolaryngology Head and Neck Surgery,Wuhan No.1 Hospital,Wuhan 430001,China;Hubei College of Traditional Chinese Medicine,Wuhan 430001,China)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2020年第3期288-291,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
湖北省卫计委科研课题面上项目(WJ2017M179)。
关键词
搏动性耳鸣
乙状窦缺损
外科手术
Pulsatile Tinnitus
Sigmoid sinus dehiscence
Surgical Procedures
