耳后肌骨膜瓣乙状窦窦壁修补术治疗搏动性耳鸣  

Sigmoid Sinus Wall Reinforcement with Posterior Auricular Periosteal Flap for Pulsatile Tinnitus

作　　者：梁华 石书婧 田永涛 王学霞 范志涛 韩丽娜 王春华 LIANG Hua;SHI Shujing;TIAN Yongtao;WANG Xuexia;FANG Zhitao;HAN Lina;WANG Chunhua(Department of Otolaryngology Head and Neck Surgery,Heibei Provincial Eye Hospital)

机构地区：[1]河北省眼科医院耳鼻咽喉科

出　　处：《中华耳科学杂志》2019年第4期589-592,共4页Chinese Journal of Otology

摘　　要：目的:探讨耳后肌骨膜瓣乙状窦窦壁修补术治疗搏动性耳鸣效果。方法通过对2010.1—2016.10在我科住院的25例V级搏动性耳鸣患者,查颞骨薄层CT提示乙状窦壁与乳突气房间隔薄弱、或者乙状窦外壁菲薄、缺损,入院后均行耳后肌骨膜瓣乙状窦窦壁修补术治疗,评价耳后肌骨膜瓣乙状窦窦壁修补术治疗搏动性耳鸣效果。结果25例患者中21例耳鸣患者均为女性,4例为男性;其中右侧18例,左侧7例;年龄25-60岁,中位数42岁,病史6月-6年,有2年以上高血压病史7例,腔隙性脑梗塞病史5年1例,施行耳后肌骨膜瓣乙状窦窦壁修补术后,23例术后即刻治愈,搏动性耳鸣完全消失,2例耳鸣响度明显减弱,术后6月、12月电话随访此2例病人耳鸣时有时无,响度≤Ⅱ级,全部病例随访2年以上,没有复发或加重病例。结论耳后肌骨膜瓣修补乙状窦窦壁治疗搏动性耳鸣简单有效,对患者身体条件要求小,创伤小;可以在临床推广使用,但需术前仔细评估。Objective To report outcomes of sigmoid sinus wall reinforcement using with posterior auricular periostealflap for the treatment of pulstile tinnitus.Method Patients diagnosed with Class V pulstile tinnitus(n=25)at theDepartment of Otolaryngology Head and Neck Surgery of Heibei Provincial Eye Hospital from January 2010 to October2016 received surgery to reinforce sigmoid sinus wall using posterior auricular periosteal flap.Result Complete resolutionof tinnitus was achieved after the surgery in 23 of the 25 patients,while tinnitus noticeably improved in the remaining2 patients,who continued to report intermittently present<Class II tinnitus during the 6 to 12 month telephonefollow up.All patients were followed up for over 2 years and reported no recurrent or worsening tinnitus.ConclusionSigmoid sinus reinforcement with posterior auricular periosteal flap is a simple,effective and minimally invasive way totreat pulstile tinnitus with minimal requirement on patient general conditions.It is worth adaptation in clinical practice,although careful assessment is needed before surgery.

关 键 词：搏动性耳鸣 乙状窦窦壁修补术 

分 类 号：R764[医药卫生—耳鼻咽喉科]