以搏动性耳鸣就诊的外伤性颞浅动静脉瘘1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2024.096

摘要/Abstract

摘要： 目的探讨外伤性颞浅动静脉瘘致搏动性耳鸣的解剖机制、诊疗方案及预后。方法分析1例左颞部外伤术后出现左耳前包块伴搏动性耳鸣患者的临床资料,并回顾相关文献。结果外伤性颞浅动静脉瘘致搏动性耳鸣少见,该病例诊断依赖于患者颞部外伤手术史、听诊局部有血管杂音及耳前多普勒超声和头颈部CTA检查,左颞浅动静脉结扎及局部包块切除术为有效治疗手段,与文献报道一致。结论外伤性颞浅动静脉瘘致搏动性耳鸣的诊断需依靠病史、临床症状和体征,头颈部CTA可明确诊断,传统的包块切除及血管结扎可获得稳定持久的疗效。

关键词: 搏动性耳鸣, 颞浅动静脉瘘, 外伤, CT血管造影, 血管结扎

Abstract: Objective To investigate the anatomical mechanism, imaging characteristics and surgical effect of pulsatile tinnitus caused by traumatic superficial temporal arteriovenous fistula. Methods To analyze the clinical data of a patient with left ear anterior mass and pulsatile tinnitus after a history of left ear trauma. The patient was confirmed as superficial temporal arteriovenous fistula by superficial B-ultrasound and head and neck CT angiography. The symptoms were improved after Surgical method of mass resection and vascular ligation. The clinical characteristics and curative effect were analyzed. Results The patient had a history of left ear trauma, and had subcutaneous mass with pulsatile tinnitus after injury. The physical examination found that there was local vascular murmur. After surgical method of mass resection and vascular ligation, pulsatile tinnitus disappeared. The patients were followed up for half a year after operation, and the symptoms did not recur. Conclusion The diagnosis of pulsatile tinnitus caused by traumatic superficial temporal arteriovenous fistula depends on clinical symptoms and signs. CTA of head and neck can make a definite diagnosis, and traditional mass resection and vascular ligation can obtain stable and lasting curative effect.

Key words: Pulsatile tinnitus, Superficial temporal arteriovenous fistula, Traumatic, Computed tomograph angiograph, Vascular ligation

中图分类号:

R764.45

卜苓南,李茂才,宫丽丽. 以搏动性耳鸣就诊的外伤性颞浅动静脉瘘1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 101-104.

BU Lingnan, LI Maocai, GONG Lili. Pulsatile tinnitus caused by traumatic superficial temporal arteriovenous fistula: a case report and liferature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 101-104.

参考文献

[1] 李熙星, 崔卫娜. 搏动性耳鸣的病因分类[J/OL].听力学及言语疾病杂志:(2024-01-13). [2024-04-17]. https://link.cnki.net/urlid/42.1391.R.20240111.1727.028
[2] Li F, Zhu SG, Liu YG, et al. Traumatic arteriovenous fistula of the superficial temporal artery[J]. J Clin Neurosci, 2007, 14(6): 595-600. doi:10.1016/j.jocn.2006.04.011
[3] Moran AM, Aleman TS, Gausas RE, et al. Traumatic arteriovenous fistula of the superficial temporal artery: a histopathologic report[J]. Ophthalmic Plast Reconstr Surg, 2013, 29(5): 126-128. doi:10.1097/IOP.0b013e31827ab9ef
[4] Bekele K, Gezahegn H. Traumatic arteriovenous fistula of superficial temporal vessel: a rare case report[J]. Int Med Case Rep J, 2021, 14: 483-485. doi:10.2147/IMCRJ.S313259
[5] Juan-Carpena G, Palazón-Cabanes JC, Gallego-León JI, et al. Spontaneous arteriovenous fistula of the superficial temporal artery misdiagnosed as hemangioma[J]. Dermatol Ther, 2021, 34(1): e14723. doi:10.1111/dth.14723
[6] Nagasaka S, Fukushima T, Goto K, et al. Treatment of scalp arteriovenous malformation[J]. Neurosurgery, 1996: 671-677. doi:10.1097/00006123-199604000-00007
[7] Yagi S, Saijo Y, Matsuda T, et al. Mass on the head: spontaneous arteriovenous fistula of the superficial temporal artery[J]. J Med Invest, 2019, 66(1.2): 209-210. doi:10.2152/jmi.66.209
[8] 朱慧慧, 王小林, 韩跃峰. 乙状窦双憩室致搏动性耳鸣1例报道并文献复习[J]. 中华解剖与临床杂志, 2023, 28(10): 667-671. doi:10.3760/cma.j.cn101202-20230117-00019 ZHU Huihui, WANG Xiaolin, HAN Yuefeng. Pulsatile tinnitus induced by sigmoid sinus double diverticula: a case report and literature review[J]. Chinese Journal of Anatomy and Clinics, 2023, 28(10): 667-671. doi:10.3760/cma.j.cn101202-20230117-00019
[9] 郑永波, 赵宇, 娄麟, 等. 静脉源性搏动性耳鸣手术治疗的疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 26-31. doi: doi:10.6040/j.issn.1673-3770.1.2019.049 ZHENG Yongbo, ZHAO Yu, LOU Lin, et al. Effects of surgery in patients with venous pulsatile tinnitus[J]. J Otolaryngol Ophthalmol Shandong Univ, 2019, 33(5):26-31. doi:10.3760/cma.j.cn101202-20230117-00019
[10] Biegaj E, Rutkowska-Zimirska J, Radzymińska-Maliszewska M, et al. Arteriovenous fistula of superficial temporal vessels[J]. Folia Morphol, 2019, 78(4): 879-882. doi:10.5603/fm.a2019.0016
[11] Matsumoto H, Yamaura I, Yoshida Y. Identity of growing pulsatile mass lesion of the scalp after blunt head injury: case reports and literature review[J]. Trauma Case Rep, 2018, 17: 43-47. doi:10.1016/j.tcr.2018.09.010
[12] Stapleton CJ, Fusco MR, Thomas AJ, et al. Traumatic pseudoaneurysms of the superficial temporal artery: case series, anatomy, and multidisciplinary treatment considerations[J]. J Clin Neurosci, 2014, 21(9): 1529-1532. doi:10.1016/j.jocn.2014.02.004
[13] Alawneh K, Abuzayed B, Al Qawasmeh M, et al. Scalp arteriovenous malformation resection with novel technique of endovascular and surgical devascularization[J]. J Craniofacial Surg, 2019, 30(8): 2582-2585. doi:10.1097/scs.0000000000005670
[14] Asai K, Tani S, Imai Y, et al. Traumatic arteriovenous fistula of the superficial temporal artery[J]. J Surg Case Rep, 2015(12): rjv156. doi:10.1093/jscr/rjv156
[15] Yang M, Pan L, Cai MJ, et al. Spontaneous arteriovenous fistula of the superficial temporal artery: diagnosis and treatment[J]. Clin Neurol Neurosurg, 2014, 123: 18-24. doi:10.1016/j.clineuro.2014.05.001
[16] Xue B, Yi L, Chao Y. Surgical resection of a complex multiple scalp avf without preoperative embolization: a case report[J]. Turk Neurosurg, 2015, 25(4): 638-642. doi:10.5137/1019-5149.JTN.8707-13.2
[17] Singla A, Fargen KM, Hoh B. Onyx extrusion through the scalp after embolization of dural arteriovenous fistula[J]. J Neurointerv Surg, 2016, 8(9): e38. doi:10.1136/neurintsurg-2015-011879.rep
[18] 赵常发, 买买提力·艾沙, 卡合尔曼·卡德尔, 等. 头皮动静脉瘘五例并文献复习[J]. 中国脑血管病杂志, 2022, 19(2): 116-121. doi: 10.3969 /j.issn.1672-5921.2022.02.007 ZHAO Changfa, Maimaitili Aisha, Kaheerman Kadeer, et al. Scalp arteriovenous fistula: report of five cases and literature review[J]. Chin J Cerebrovasc Dis, 2022, 19(2): 116-121. doi: 10.3969 /j.issn.1672-5921.2022.02.007
[19] Sofela A, Osunronbi T, Hettige S. Scalp cirsoid aneurysms: case illustration and systematic review of literature[J]. Neurosurgery, 2020, 86(2): E98-E107. doi:10.1093/neuros/nyz303
[20] Visser A, FitzJohn T, Tan ST. Surgical management of arteriovenous malformation[J]. J Plast Reconstr Aesthet Surg, 2011, 64(3): 283-291. doi:10.1016/j.bjps.2010.05.033

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