回流优势侧乙状窦相关性血管搏动性耳鸣的外科技术与疗效

Surgical technique and effect of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux

目的:探讨回流优势侧乙状窦相关性搏动性耳鸣的临床外科技术及疗效。方法:回顾性研究2017年1月-2023年11月由同一位医生收治的43例回流优势侧搏动性耳鸣患者的临床资料,观察手术治疗的疗效。术式:应用“盖帽法”乙状窦骨壁缺损修复技术建立隔声屏障,不改变乙状窦血管壁和血流流变状态。结果:所有患者均未出现手术并发症。随访3个月~6.9年,43例患者痊愈14例(32.6%),显效18例(41.9%),有效4例(9.3%),无效7例(16.3%),手术前后耳鸣分级的差异有统计学意义(P<0.05)。结论:应用“盖帽法”乙状窦骨壁缺损修复技术建立隔声屏障,有效地规避了对血液流变学状态及血管壁的干扰,从而避免了优势回流侧静脉管壁狭窄及血栓形成的风险,手术方法容易掌握,疗效显著,值得临床推广。

Objective To explore the effect of surgical treatment of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux.Methods The clinical data of 43 patients with reflux dominant side pulsating tinnitus admitted by the same doctor from 2017 to 2023 were retrospectively studied to observe the curative effect of surgical treatment.Operation method:The sound insulation barrier was established by repair technique of bone wall defect of sigmoid sinus with"capping method",without changing the blood flow and blood vessel wall of sigmoid sinus.Results No surgical complications occurred in all patients.During the follow-up period of 3 months to 6.9 years,14 patients(32.6%)were cured,18 patients(41.9%)were significantly effective,4 patients(9.3%)were effective,and 7 patients(16.3%)were ineffective.The difference of tinnitus grade before and after surgery was statistically significant.Conclusion In this group of cases,the sound insulation barrier was established by"capping method"technique of repairing bone wall defect of sigmoid sinus,which effectively avoided the disturbance of hemorheology status and vascular wall,thus avoiding the risk of venous wall stenosis and thrombosis on the dominant reflux side.The surgical method was easy to master,and the curative effect was significant,which was worthy of clinical promotion.