乙状窦缩窄术治疗搏动性耳鸣

Sigmoid sinus constriction for pulsatile tinnitus

摘要:

目的 探讨乙状窦缩窄术治疗搏动性耳鸣的疗效。方法 选取中国人民解放军联勤保障部队第九四〇医院2014年8月—2019年8月收治的11例患者，用耳鸣致残量化表（THI）均评估为重度搏动性耳鸣，所有患者均为单耳发病，其中右耳9例，左耳2例，均为客观性搏动性耳鸣。术前行颞骨薄层CT检查提示9例右耳乙状窦憩室；1例左耳乙状窦憩室；1例左耳乙状窦憩室合并骨壁缺损，乙状窦暴露于乳突腔。入院后完善相关术前检查后均行乙状窦缩窄术治疗，术后观察治疗搏动性耳鸣的疗效。结果 术后定期采用THI和耳鸣功能指数（TFI）对患者进行耳鸣评估，10例术后搏动性耳鸣即刻完全消失，1例耳鸣响度明显减弱，随诊1年后搏动性耳鸣基本消失。结论 乙状窦缩窄术治疗搏动性耳鸣，手术创伤小、操作风险小，是治疗乙状窦憩室和骨壁缺损所引起的搏动性耳鸣最佳的手术方式，可临床推广。

Abstract:

Objective To investigate the effect of sigmoid sinus constriction on pulsating tinnitus. Methods Eleven patients with severe pulsatile tinnitus admitted to the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from Aug 2014 to Aug 2019 were included in this study. They were evaluated using tinnitus disability quantitative table (THI) and diagnosed as unilateral objective pulsatile tinnitus involving right ear in 9 cases and left in 2. Preoperative temporal bone CT examination revealed right sigmoid sinus diverticulum in 9 cases, left sigmoid sinus diverticulum in one and left sigmoid sinus diverticulum with bone wall defect in another. All the patients were treated with sigmoid sinus constriction and the therapeutic effect was observed. Results All the patients were evaluated for tinnitus by THI and tinnitus function index (TFI). Of them, pulsatile tinnitus disappeared immediately after operation in 10 cases, and tinnitus loudness was significantly reduced in one and tinnitus was basically eliminated in one year. Conclusion With advantages of minor surgical trauma and low surgical risk, sigmoid sinus constriction is the best surgical method to treat pulsating tinnitus caused by diverticula of sigmoid sinus and bone wall defect and is worth promoting clinically.