中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
4期
265-269
,共5页
耳鸣%颅窦%磁共振血管造影术
耳鳴%顱竇%磁共振血管造影術
이명%로두%자공진혈관조영술
Tinnitus%Cranial sinuses%Magnetic resonance angiography
目的 探讨乙状窦缩窄术对乙状窦相关静脉源性搏动性耳鸣的治疗效果.方法 回顾性分析12例乙状窦相关静脉源性搏动性耳鸣患者的临床资料,比较手术前后耳鸣严重程度和磁共振静脉造影成像上的改变,初步评价乙状窦缩窄术对搏动性耳鸣的治疗效果.结果 12例患者中女11例,男1例,年龄21～61岁；左侧1例,右侧11例.颞骨高分辨率CT检查,12例均有乙状窦外突,3例同时出现乙状窦憩室.10例行磁共振血管造影检查,9例术前显示右侧颈内静脉与静脉窦优势引流,1例为左侧颈内静脉与静脉窦优势引流,患侧乙状窦的横截面积是健侧的2～3倍.12例患者均在局部麻醉下行乳突探查+乙状窦缩窄术.术前耳鸣严重程度评估V级3例,Ⅳ级7例,Ⅲ级2例；术后3个月复查,Ⅰ级11例,Ⅱ级1例.术后4～ 40个月随访耳鸣的治疗效果,11例有效,1例无效.治疗有效的患者术后磁共振静脉造影乙状窦缩窄程度在46％ ～ 83％之间.结论 乙状窦缩窄术对静脉源性搏动性耳鸣是一种可以尝试的有效治疗手段.
目的 探討乙狀竇縮窄術對乙狀竇相關靜脈源性搏動性耳鳴的治療效果.方法 迴顧性分析12例乙狀竇相關靜脈源性搏動性耳鳴患者的臨床資料,比較手術前後耳鳴嚴重程度和磁共振靜脈造影成像上的改變,初步評價乙狀竇縮窄術對搏動性耳鳴的治療效果.結果 12例患者中女11例,男1例,年齡21～61歲；左側1例,右側11例.顳骨高分辨率CT檢查,12例均有乙狀竇外突,3例同時齣現乙狀竇憩室.10例行磁共振血管造影檢查,9例術前顯示右側頸內靜脈與靜脈竇優勢引流,1例為左側頸內靜脈與靜脈竇優勢引流,患側乙狀竇的橫截麵積是健側的2～3倍.12例患者均在跼部痳醉下行乳突探查+乙狀竇縮窄術.術前耳鳴嚴重程度評估V級3例,Ⅳ級7例,Ⅲ級2例；術後3箇月複查,Ⅰ級11例,Ⅱ級1例.術後4～ 40箇月隨訪耳鳴的治療效果,11例有效,1例無效.治療有效的患者術後磁共振靜脈造影乙狀竇縮窄程度在46％ ～ 83％之間.結論 乙狀竇縮窄術對靜脈源性搏動性耳鳴是一種可以嘗試的有效治療手段.
목적 탐토을상두축착술대을상두상관정맥원성박동성이명적치료효과.방법 회고성분석12례을상두상관정맥원성박동성이명환자적림상자료,비교수술전후이명엄중정도화자공진정맥조영성상상적개변,초보평개을상두축착술대박동성이명적치료효과.결과 12례환자중녀11례,남1례,년령21～61세；좌측1례,우측11례.섭골고분변솔CT검사,12례균유을상두외돌,3례동시출현을상두게실.10례행자공진혈관조영검사,9례술전현시우측경내정맥여정맥두우세인류,1례위좌측경내정맥여정맥두우세인류,환측을상두적횡절면적시건측적2～3배.12례환자균재국부마취하행유돌탐사+을상두축착술.술전이명엄중정도평고V급3례,Ⅳ급7례,Ⅲ급2례；술후3개월복사,Ⅰ급11례,Ⅱ급1례.술후4～ 40개월수방이명적치료효과,11례유효,1례무효.치료유효적환자술후자공진정맥조영을상두축착정도재46％ ～ 83％지간.결론 을상두축착술대정맥원성박동성이명시일충가이상시적유효치료수단.
Objective To discuss the diagnosis and management of venous original pulsatile tinnitus associated with sigmoid sinus.Methods A retrospective study was conducted on 12 patients who were diagnosed with venous original pulsatile tinnitus associated with sigmoid sinus,and treated with sigmoid sinus constriction surgery.The diagnostic evidences for venous original pulsatile tinnitus associated with sigmoid sinus were re-evaluated,the pulsatile tinnitus improvements and MRV study results before and after surgeries associated with sigmoid sinus were compared.Results Eleven patients got relief of tinnitus within three months after the surgeries,while one patient had no relief.There were ten patients underwent MRV study,the cxoss-sectional area of the sigmoid sinus in the healthy side was about two times in the tinnitus side.Constriction sigmoid sinus was performed on the twelve patients.The cross-sectional area of the sigmoid sinus of relieved tinnitus patients were compressed by forty-six percent to eighty-three percent.None of the cases complained of any serious complications.Conclusions Sigmoid sinus constriction is an available therapy for pulsatile tinnitus at present.More cases and longer follow-up are necessary to evaluate its treatment effect accurately.
