乙状窦憩室致搏动性耳鸣手术治疗的疗效分析

Analysis of the surgical effect of the pulsatile tinnitus caused by sigmoid sinus diverticulum

目的探讨乙状窦憩室引起的搏动性耳鸣手术治疗的效果。方法通过对2010年3月~2014年6月期间在我院诊断为乙状窦憩室引起的搏动性耳鸣并接受手术治疗的32例患者的临床资料进行回顾性总结和分析,评价乙状窦憩室回纳术对搏动性耳鸣的治疗效果。结果 32例患者中女性29例,年龄30~62岁,男性3例,年龄32~47岁;左侧4例,右侧28例。术前颞骨高分辨率CT检查,32例患者中均有不同程度乙状窦憩室。术前综合检查排除患耳中耳炎及肿瘤,患耳无手术、外伤史,无高血压病、甲状腺疾病及糖尿病等基础病病史。全部患者均行乙状窦憩室回纳术,术后均无眩晕、恶心呕吐、脑脊液漏等并发症,1例患者因鼓室积血引起短期的低调耳鸣,经对症处理后症状消失,7例耳鸣明显减轻,24例患者耳鸣消失。随访6~36个月,32例患者搏动性耳鸣均完全消失,无反复。结论乙状窦憩室致搏动性耳鸣的手术治疗风险较小,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 sinus diverticulum. METHODS A retrospective summary and analysis of 32 cases of patients of pulsatile tinnitus caused by sigmoid sinus diverticulum who received surgical treatment during March 2010 to June 2014 in our hospital was performed. The effect of sigmoid sinus diverticulum back surgery was evaluated. RESULTS Among 32 patients, 29 caseswere female aged 30-62 years old, 3 caseswere male aged 32-47 years old. The lesion of 4 cases was on the left side, and 28 cases on the right side. High resolution CT scan of temporal bone was performed preoperativelyand all 32 patientshave different degrees of sigmoid sinus diverticulum.Preoperative comprehensive check had ruled out ear infections and tumors, history of ear surgery or trauma, other diseases such as hypertension, thyroid disease, and diabetes.All patients had no postoperative complications such as dizziness, nausea, vomiting, cerebrospinal fluid leakage. One patient had low-key tinnitus caused by hemotympanum for a short timeand his symptoms disappeared after symptomatic treatment. After surgery, tinnitus of 7 cases were significantly reduced, tinnitus of 24 patients were disappeared. After follow up for 6-36 months, pulsatile tinnitus of 32 cases were completely disappeared, without recurrence. CONCLUSION Surgical treatment for pulsatile tinnitus caued by sigmoid sinus diverticulum was an effective treatment with less risk. It is worthy to clinical apply and develop.