Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (5): 26-31.doi: 10.6040/j.issn.1673-3770.1.2019.049

• Clinical Report • Previous Articles     Next Articles

Effects of surgery in patients with venous pulsatile tinnitus

Yongbo ZHENG,Yu ZHAO(),Lin LOU,Yao SONG,Yijun DONG,Jianjun REN,Jing WANG,Yang XU,Lei LEI   

  1. Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
  • Received:2019-07-25 Revised:2019-07-29 Online:2019-09-20 Published:2019-10-15
  • Contact: Yu ZHAO E-mail:yutzhao@163.com

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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

CLC Number: 

  • R764.65

Fig. 1

Right sigmoid sinus and jugular bulb abnormalities A-C: Right sigmoid sinus expansion; D-F: right sigmoid sinus expansion and right high jugular bulb expansion."

Fig. 3

Right jugular bulb and bilateral mastoid emissary vein abnormalities A: Right high jugular bulb; B: left mastoid emissary vein showing abnormal position and expansion; C: right mastoid emissary vein malformation."

Fig. 2

Right sigmoid sinus and mastoid emissary vein abnormalities A: Right sigmoid sinus diverticulum; B: right mastoid emissary vein expansion; C-D: right sigmoid sinus and jugular bulb expansion."

Fig.4

Example of a posterior auricular incision"

Fig.5

Intraoperative exposure and tamponade of abnormal sigmoid sinus A-B: Exposure of the abnormal sigmoid sinus; C-D: Use of the temporalis muscle flap to fill the sigmoid sinus."

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