血管源性搏动耳鸣的介入诊断和治疗研究

发布时间：2018-06-23 08:57

本文选题：搏动性耳鸣 + AVF　；参考：《中华耳科学杂志》2014年02期

【摘要】：目的回顾性探讨血管源性搏动耳鸣的影像学诊断、发病特点和经血管内介入治疗的可行性和临床效果。方法本组分析了82例动脉和静脉源性搏动耳鸣的DSA不同特征和可能的病理生理机制,对3例颅内动静脉瘘,16例自发性颅底脑膜动静脉瘘,5例外伤性颈动脉海绵窦瘘,2例锁骨下动脉狭窄,3例颈动脉狭窄,1例颅内动脉狭窄,2例椎-基底动脉迂曲延长,2例静脉窦憩室,46例优势引流侧的静脉窦狭窄,2例枕窦狭窄分别经股动脉和股静脉入路,选用螺旋圈、NBCA胶、Balt球囊、自膨式支架和颅内微支架性行栓塞与支架成形处理。结果 82例介入手术均获成功,未发生与介入手术相关的并发症,术后搏动性耳鸣在2天内均消失。平均门诊随访5~36月,4例动脉源性耳鸣于介入术后3月复发搏动性耳鸣,经二次栓塞和对症处理后症状缓解;静脉源性搏动性耳鸣病例在支架成形和支架辅助螺旋圈栓塞后均未出现复发征像。结论应用经血管内的诊治方式可能对临床诊断和治疗顽固的搏动性耳鸣提供新的选择途径,有助于为鉴别和研究其他类型的耳鸣提供一定的理论和技术依据。
[Abstract]:Objective to investigate retrospectively the imaging diagnosis, pathogenesis, feasibility and clinical effect of vascular pulsatile tinnitus. Methods the different features and possible pathophysiological mechanisms of arterial and venous tinnitus in 82 cases were analyzed. Three cases of intracranial arteriovenous fistula 16 cases of spontaneous skull base arteriovenous fistula 5 cases of traumatic carotid cavernous sinus fistula 2 cases of subclavian artery stenosis 3 cases of carotid artery stenosis 1 case of intracranial artery stenosis 2 cases of vertebrobasilar artery detour lengthening Two cases of venous sinus diverticulum and 46 cases of dominant drainage side of venous sinus stenosis 2 cases of occipital sinus stenosis via femoral artery and femoral vein approach respectively. Balt balloon, self-expandable stents and intracranial microstents were used for embolization and stenting. Results 82 cases of interventional surgery were successful, no complications related to interventional surgery occurred, and pulsatile tinnitus disappeared within 2 days after operation. Four patients with arteriogenic tinnitus were followed up from 5 to 36 months after interventional surgery. The symptoms were alleviated after secondary embolization and symptomatic treatment. Venous pulsatile tinnitus patients had no recurrence signs after stenting and stent assisted helical coil embolization. Conclusion the application of intravascular diagnosis and treatment may provide a new alternative for clinical diagnosis and treatment of persistent pulsatile tinnitus, and may provide some theoretical and technical basis for the identification and study of other types of tinnitus.
【作者单位】：解放军总医院神经内科;
【分类号】：R764.45

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