耳内镜下颈静脉球源性搏动性耳鸣的治疗

Endoscopic Treatment of Pulsatile Tinnitus Related to High Jugular Bulb

目的探讨耳内镜下微创治疗颈静脉球源性搏动性耳鸣的临床效果。方法回顾性分析2018年1月至2021年1月中国人民解放军联勤保障部队第988医院耳鼻咽喉头颈外科收治的颈静脉球源性搏动性耳鸣患者11例,依据患者不同分型,在耳内镜下经外耳道分别行颈静脉球骨壁加固术、颈静脉球骨壁重建术、颈静脉球憩室回纳术+骨壁重建术。结果术后,所有患者全身麻醉苏醒后,9例患者耳鸣症状消失,2例患者耳鸣症状减轻,并出现低调嗡嗡样耳鸣声,应用药物治疗后耳鸣症状消失。出院后1个月、2个月、3个月、6个月随访无复发病例。结论经耳内镜下手术治疗颈静脉源性搏动性耳鸣,效果肯定,损伤小,恢复快,值得临床应用。

Objective To report outcomes of minimally invasive endoscopy in the treatment of jugular bulb related pulsatile tinnitus.Methods Data from cases of jugular vein-derived pulsating tinnitus admitted from January 2018 to January 2021(n=11)were retrospectively analyzed,including clinical symptoms,physical signs,auxiliary tests and postoperative improvements.Based on the particular type of potential etiology,jugular bulb wall reinforcement,jugular bulb wall reconstruction,or jugular bulb diverticulum reduction+reconstruction was performed via an endoscopic transmeatal approach,respectively.Results Upon waking up from anesthesia,tinnitus disappeared in 9 patients,and reduced in 2 patients'with residual low-pitched humming that disappeared with drug treatments.No recurrence was reported at 1,3 and 6 months follow ups.Conclusion Otoscopic surgery is effective in the treatment of jugular spheroid wall defects related pulsating tinnitus with advantages of minimal invasiveness and speedy recovery,and can be a clinically viable treatment option.