【摘要】 [目的]研究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2015年9月至2020年7月诊断为乙状窦相关病变引起搏动性耳鸣的患者资料进行回顾性分析。接受手术治疗患者6例,均诊断为乙状窦骨壁缺损引起的搏动性耳鸣,入院检查颞骨高分辨率CT(HRCT)均提示乙状窦前外侧壁骨壁缺损,程度不同。术前检查头颈部血管CT造影(CTA+CTV)及颅内血管数字减影血管造影(DSA),排除其他原因引起搏动性耳鸣的可能。均行乳突径路下乙状窦骨壁缺损修复术。[结果]6例患者术后均自觉搏动性耳鸣消失,1例出现术后轻度恶心,术后第2天症状消失,其余患者均未出现眩晕、恶心、呕吐等颅内高压征兆,均无脑脊液漏等并发症。随访4～20 mon,搏动性耳鸣分级,6例患者中,4例患者痊愈(0级),2例显效(1级),患者满意,对生活无影响。与术前比较,均无复发。[结论]对于排除其他原因引起的,诊断为乙状窦骨壁缺损引起的搏动性耳鸣,手术疗效确切。对于确实影响患者生活质量的因乙状窦相关病变引起的搏动性耳鸣,与患者做好充分的沟通,取得患者理解后,可考虑经乳突进路乙状窦骨壁缺损修复术。更多还原

【Abstract】 [Objective] To study the clinical effect of surgical treatment on pulsating tinnitus caused by sigmoid sinus bone defect,and to provide a reliable treatment method for the clinical treatment of pulsating tinnitus.[Methods]The data of 21 patients diagnosed with pulsatile tinnitus caused by sigmoid sinus-related lesions were collected from September 2015 to July2020,and 6 patients underwent surgical treatment,all of which were diagnosed as pulsating due to sigmoid sinus bone defect tinnitus,1 male,5 females,23～59 years old,with an average age of 40.5 years,1 case on the left side and 5 cases on the right side.High-resolution CT(HRCT) of the temporal bone on admission showed that the anterior and lateral wall of the sigmoid sinus bone quality defects,varying degrees.Check head and neck angiography(CTA+CTV) and digital subtraction angiography(DSA)of the head and neck before surgery to rule out other possible causes of pulsatile tinnitus.All underwent repair of sigmoid sinus bone defect under the mastoid approach.[Results] In 6 patients,the pulsating tinnitus disappeared consciously after the operation.One case had mild nausea after the operation.The symptoms disappeared the next day after the operation.The remaining patients had no signs of intracranial hypertension such as dizziness,nausea,and vomiting.Complications such as cerebrospinal fluid leakage.Followed up for 4～20 months,pulsating tinnitus was graded.Among the 6 patients,4 patients were cured(grade 0),and 2 patients were markedly effective(grade 1).The patients were satisfied and had no impact on life.Compared with preoperatively,there was no recurrence(P<0.05).[Conclusion] For excluding other reasons,the diagnosis of pulsating tinnitus caused by sigmoid sinus bone defect is effective.For pulsatile tinnitus caused by sigmoid sinus-related lesions that do affect the quality of life of the patient,fully communicate with the patient,and after obtaining the patient’s understanding,consider transmastoid approach to repair the sigmoid sinus bone defect.更多还原