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Surgical treatment of pulsatile tinnitus related to the sigmoid sinus

Journal of Otology 2023年第1期18卷 21-25页

作者： Yuxuan Xing Song Gao Yuchen Zhou Shenghua Song Ling Lu Jie Chen Yanhong Dai Department of Otolaryngology Head and Neck Surgery Affiliated Drum Tower Hospital of Nanjing University Medical SchoolJiangsu Provincial Key Medical Discipline(Laboratory)Nanjing210008People's Republic of China Research Institute of Otolaryngology No.321 Zhongshan RoadNanjing210008People's Republic of China Department of Otolaryngology Head and Neck Surgery Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjing210008People's Republic of China

Objective: Tinnitus-a common clinical symptom-can be categorized into pulsatile tinnitus(PT) and non-PT. Among these, PT is usually associated with sigmoid sinus symptoms, such as sigmoid sinus wall defect or diverticulum, for which various surgical treatments are available. We have discussed the clinical efficacy of surgery for sigmoid sinus-associated PT via the transmastoid approach in this study.Methods: We conducted a retrospective review of 4 patients who underwent surgery for sigmoid sinusassociated PT via the transmastoid approach at Nanjing Drum Tower Hospital from January to December2020. Of these, 2 patients had sigmoid sinus wall defect and 2 had sigmoid sinus diverticulum. Postoperative tinnitus grading and surgical efficacy were determined.Results: After surgery, PT dissolved in 3 patients, while tinnitus significantly decreased in 1 patient.During the follow-up period of 12-18 months, none of the 4 patients showed complications related to increased intracranial pressure or venous sinus thrombosis, and tinnitus symptoms disappeared in 3patients without recurrence, although 1 patient occasionally developed tinnitus. Postoperative thin-slice CTA of the temporal bone indicated that the sigmoid sinus bone wall defect or diverticulum was completely repaired with a thick soft tissue coverage.Conclusion: Surgical repair of sigmoid sinus-associated PT via the transmastoid approach deserves clinical promotion as it exhibited better efficiency while being relatively less invasive.

关键词： Pulsatile tinnitus Sigmoid sinus wall defect Sigmoid sinus diverticulum Efficacy of surgery transmastoid approach

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