源于乙状窦憩室搏动性耳鸣的血管内治疗

摘要

目的 探讨源于乙状窦憩室搏动性耳鸣的血管内治疗方法,分析单纯支架置入治疗和支架辅助弹簧圈栓塞治疗的手术适应证.方法 连续选择5例女性乙状窦憩室搏动性耳鸣患者,均经数字减影血管造影和颞骨CT进行确诊.结果 2例(40％)单纯乙状窦憩室患者应用支架辅助弹簧圈栓塞治疗,3例(60％)乙状窦憩室伴横窦乙状窦交界处狭窄的患者应用静脉窦支架置入治疗.5例患者术后耳鸣症状立即消失,术后恢复良好,无手术并发症.随访1～2年,未出现耳鸣复发.结论 源于乙状窦憩室的搏动性耳鸣可通过血管内治疗治愈.单纯乙状窦憩室可应用支架辅助弹簧圈栓塞治疗,乙状窦憩室合并静脉窦狭窄的患者可应用静脉窦支架置入治疗.%Objective To study the endovascular treatment of sigmoid sinus diverticulum-induced pulsatile tinnitus and analyze the indications for plant stenting and stent-assisted embolization.Methods Five female patients aged 55 69 (60.5±5.3) years with sigmoid sinus diverticuluminduced pulsatile tinnitus admitted to our hospital from January 2012 to May 2013 were diagnosed by DSA and temporal bone CT respectively.Results Of the 5 patients with sigmoid sinus diverticulum-induced pulsatile tinnitus,2 (40％) with simple sigmoid sinus diverticulum were treated by stent-assisted coil embolization and 3 (60 ％) with sigmoid sinus diverticulum and sigmoid sinus juncture stenosis were treated by plant stenting.Pulsatile tinnitus disappeared in the 5 patients immediately after stenting.The patients recovered with no complication after stenting.Pulsatile tinnitus did not occur during the 1 2 years follow-up period.Conclusion Sigmoid sinus diverticulum-induced pulsatile tinnitus can be cured by endovascular treatment,simple sigmoid sinus diverticulum can be treated by stent-assisted coil embolization,sigmoid sinus diverticulum with venous sinus stenosis can be treated by plant stenting.