乙状窦还纳及窦壁重建术治疗搏动性耳鸣的疗效分析  

Analysis of therapeutic effect of sigmoid sinus repayment and sinus wall reconstruction in pulsatile tinnitus

作　　者：孙瑜宁[1] 孙茂钢 张恩东[1] SUN Yuning;SUN Maogang;ZHANG Endong(Department of Otolaryngology Head and Neck Surgery,Weihai Municipal Second Hospital affiliated to Qingdao University,Weihai 264200,China)

机构地区：[1]青岛大学附属威海市立第二医院耳鼻咽喉头颈外科,山东威海264200

出　　处：《中国耳鼻咽喉颅底外科杂志》2023年第5期91-95,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：山东省医药卫生科技发展计划面上项目(202207010234)。

摘　　要：目的观察乙状窦还纳术及窦壁重建术治疗乙状窦憩室及骨壁缺损引起的血管搏动性耳鸣的手术疗效。方法回顾性分析2019年1月-2021年9月威海市立第二医院耳鼻咽喉头颈外科收治的7例血管搏动性耳鸣患者的临床资料,观察术后当天、1个月、6个月、1年耳鸣变化情况。结果7例患者均为女性,右侧发病6例,左侧发病1例。根据临床表现及颞骨薄层CT及颅脑MRA、MRV检查确诊为乙状窦源性血管搏动性耳鸣,耳鸣致残量化表(THI)评分分级,均为3级以上,7例患者均在全麻下手术,其中6例乙状窦憩室伴发乙状窦骨质缺损患者接受乙状窦憩室回纳及窦壁重建术治疗,1例合并横窦憩室患者接受乙状窦、横窦憩室回纳+窦壁重建术治疗。术后1年随访,痊愈5例、显效1例、有效1例。结论对乙状窦憩室或骨壁缺损引起的搏动性耳鸣进行乙状窦还纳术及窦壁重建术疗效确切,值得临床借鉴。Objective To observe the surgical effect of sigmoid sinus repayment and sinus wall reconstruction for vascular pulsatile tinnitus caused by sigmoid sinus diverticulum and bone wall defect.Methods It was analyzed retrospectively for the clinical data of 7 patients with vascular pulsating tinnitus admitted to the Department of Otolaryngology Head and Neck Surgery of Weihai Municipal Second Hospital affiliated from January 2019 to September 2021.It was observed for the changes of tinnitus on the day,one month,six months and one year after operation.Results All of the 7 patients were female.Six patients of them were on the right side and 1 patient on the left side.After clinical manifestations,thin slice CT of temporal bone,brain MRA and MRV examination,the patients were confirmed pulsatile tinnitus caused by sigmoid sinus origin.Tinnitus handicap inventory(THI)scores of all patients were grade III or above.All patients were operated under general anesthesia,of which 6 patients with sigmoid sinus diverticulum accompanied by sigmoid sinus bone defect received sigmoid sinus diverticulum repayment and sinus wall reconstruction,and 1 patient with transverse sinus diverticulum received sigmoid sinus and transverse sinus repayment and sinus wall reconstruction.After 1 year follow-up,5 cases were cured,1case was markedly effective and 1 case was effective.Conclusion The effect of sigmoid sinus plasty for pulsatile tinnitus caused by sigmoid sinus diverticulum or bone wall defect are effective and worthy of clinical reference.

关 键 词：搏动性耳鸣 乙状窦还纳 窦壁重建 乙状窦憩室 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]