静脉源性搏动性耳鸣手术治疗的疗效分析

doi:10.6040/j.issn.1673-3770.1.2019.049

摘要/Abstract

摘要： 目的

对静脉源性搏动性耳鸣患者的发病特征进行总结，为该疾病的临床诊疗提供参考。

方法

收集分析25例静脉源性搏动性耳鸣行手术治疗患者的临床资料。手术主要采用局麻下耳后小切口行乳突探查加乙状窦缩窄术或乙状窦回纳术。对患者术前及术后1个月、3个月及6个月的耳鸣情况采用耳鸣评价量表（TEQ）进行评分，量化评估患者术后耳鸣的改善效果。同时比较患者术前与术后1个月的听力检查结果，评估手术是否对听力产生不良影响。

结果

根据患者主诉，21例患者术后随访期内搏动性耳鸣消失，4例患者在术后第6个月随访时仍有轻微搏动性耳鸣，但患者自觉耳鸣对日常生活无影响。本组患者术前TEQ评分为10.44±3.08，术后1个月TEQ评分为3.68±1.75，术后3个月TEQ评分为2.76±1.23，术后6个月TEQ评分为2.72±1.17。术后1个月、术后3个月及术后6个月TEQ评分均低于术前，表明患者术后耳鸣症状得到明显改善。术后3个月及术后6个月的TEQ评分低于术后1个月，但术后3个月与术后6个月的TEQ评分比较无统计学意义，表明患者术后耳鸣的改善程度逐渐趋于稳定。本组患者术后1个月听力检查结果与术前相比较无统计学差异。

结论

静脉源性搏动性耳鸣可通过仔细询问病史、查体及影像学检查进行诊断。采用局麻下手术治疗便于术者术中观察患者耳鸣改善情况，准确掌握对乙状窦的塑形程度，减少并发症发生率。

关键词: 搏动性耳鸣, 手术, 疗效

Abstract: Objective

To summarize the clinical characteristics of patients with venous pulsatile tinnitus and provide reference data for clinical diagnosis and treatment of this disease.

Methods

Clinical data of 25 patients with venous pulsatile tinnitus were analyzed. During surgery, a small incision was made in the posterior auricular region under local anesthesia, and mastoid exploration plus sigmoid sinus constriction or sigmoid sinus retraction were performed. The tinnitus evaluation questionnaire (TEQ) was used to quantify improvement in tinnitus after the operation (1st, 3rd, and 6th months). The preoperative hearing test results were compared with those obtained in the 1st month postoperatively to determine whether the surgery had adverse effects on hearing.

Results

As reported by the patients, pulsatile tinnitus had disappeared during the follow-up period in 21 patients. Four patients had mild pulsatile tinnitus in the 6th month postoperatively; however, this conscious tinnitus did not affect the patients’daily lives. The preoperative TEQ score of the patients was 10.44±3.08. The postoperative TEQ scores in the 1st, 3rd, and 6th months were 3.68±1.75, 2.76±1.23, and 2.72±1.17, respectively, which were significantly lower than the preoperative TEQ score. The postoperative TEQ scores in the 3rd and 6th months were lower than that in the 1st month postoperatively, but there was no statistical difference between the TEQ scores in the 3rd and 6th months postoperatively. It was observed that the improvement in postoperative tinnitus stabilized gradually. There was no significant difference between the preoperative and postoperative hearing test results.

Conclusion

Venous pulsatile tinnitus can be diagnosed by careful medical history taking, physical examination, and imaging. Surgery under local anesthesia is convenient for the surgeon to observe real-time improvement in tinnitus, which aids in accurate evaluation of the shape of the sigmoid sinus and reducing the incidence of complications. Therefore, its clinical application is recommended.

Key words: Pulsatile tinnitus, Surgery, Therapeutic effect

中图分类号:

R764.65

郑永波, 赵宇, 娄麟, 宋瑶, 董怡君, 任建君, 王晶, 许洋, 雷蕾. 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.

Yongbo ZHENG, Yu ZHAO, Lin LOU, Yao SONG, Yijun DONG, Jianjun REN, Jing WANG, Yang XU, Lei LEI. Effects of surgery in patients with venous pulsatile tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 26-31.

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