PDF(Pubmed)
Abstract：
BACKGROUND: Sigmoid sinus wall dehiscence can lead to pulsatile tinnitus with a significant decrease in quality of life, occasionally leading to psychiatric disorders. Several surgical and endovascular procedures have been described for resolving dehiscence. Within endovascular procedures, the sagittal sinus approach could be a technical alternative for tracking and accurate stent positioning within the sigmoid sinus when the jugular bulb anatomy is unfavorable.
METHODS: A retrospective case series of three patients with pulsatile tinnitus due to sigmoid sinus wall dehiscence without intracranial hypertension was reviewed from January 2018 to January 2022. From the participants enrolled, the median age was 50.3 years (range 43-63), with 67% self-identifying as female and 33% as male. They self-identified as Hispanic. Sigmoid sinus dehiscence was diagnosed using angiotomography, and contralateral transverse sinus stenosis was observed in all patients. Patients underwent surgery via a navigated endovascular sagittal sinus approach for sigmoid sinus stenting. No neurological complications were associated with the procedure. Pulsatile tinnitus improved after the procedure in all patients.
CONCLUSIONS: Superior sagittal sinus resection for sigmoid sinus wall stenting is a safe and effective technique. Pulsatile tinnitus due to sigmoid sinus wall dehiscence could be treated using the endovascular resurfacing stenting technique. However, further research is needed to evaluate the potential benefit of contralateral stenting for removing sinus dehiscence when venous stenosis is detected. However, resurfacing sigmoid sinus wall dehiscence results in symptomatic improvement.
METHODS: A retrospective case series of three patients with pulsatile tinnitus due to sigmoid sinus wall dehiscence without intracranial hypertension was reviewed from January 2018 to January 2022. From the participants enrolled, the median age was 50.3 years (range 43-63), with 67% self-identifying as female and 33% as male. They self-identified as Hispanic. Sigmoid sinus dehiscence was diagnosed using angiotomography, and contralateral transverse sinus stenosis was observed in all patients. Patients underwent surgery via a navigated endovascular sagittal sinus approach for sigmoid sinus stenting. No neurological complications were associated with the procedure. Pulsatile tinnitus improved after the procedure in all patients.
CONCLUSIONS: Superior sagittal sinus resection for sigmoid sinus wall stenting is a safe and effective technique. Pulsatile tinnitus due to sigmoid sinus wall dehiscence could be treated using the endovascular resurfacing stenting technique. However, further research is needed to evaluate the potential benefit of contralateral stenting for removing sinus dehiscence when venous stenosis is detected. However, resurfacing sigmoid sinus wall dehiscence results in symptomatic improvement.
摘要：
背景：乙状窦壁裂开可导致搏动性耳鸣，生活质量显着下降，偶尔会导致精神疾病。已经描述了几种用于解决裂开的外科手术和血管内手术。在血管内手术中，当颈静脉球解剖结构不利时,矢状窦入路可以作为在乙状窦内跟踪和准确定位支架的技术替代方案.
方法：回顾了2018年1月至2022年1月3例因乙状窦壁裂开而无颅内高压的搏动性耳鸣患者的回顾性病例系列。从注册的参与者中，中位年龄为50.3岁（范围为43-63岁），67%的人自我认同为女性，33%的人自我认同为男性。他们自称为西班牙裔。血管造影诊断为乙状窦裂开，所有患者均观察到对侧横窦狭窄。患者通过导航血管内矢状窦入路进行乙状窦支架置入手术。无与手术相关的神经系统并发症。所有患者术后搏动性耳鸣均得到改善。
结论：上矢状窦切除术用于乙状窦壁支架置入术是一种安全有效的技术。由于乙状窦壁裂开引起的搏动性耳鸣可以使用血管内表面修复支架技术进行治疗。然而,当检测到静脉狭窄时,需要进一步的研究来评估对侧支架置入术对去除窦口裂开的潜在益处.然而,重修乙状窦壁裂开可改善症状.
方法：回顾了2018年1月至2022年1月3例因乙状窦壁裂开而无颅内高压的搏动性耳鸣患者的回顾性病例系列。从注册的参与者中，中位年龄为50.3岁（范围为43-63岁），67%的人自我认同为女性，33%的人自我认同为男性。他们自称为西班牙裔。血管造影诊断为乙状窦裂开，所有患者均观察到对侧横窦狭窄。患者通过导航血管内矢状窦入路进行乙状窦支架置入手术。无与手术相关的神经系统并发症。所有患者术后搏动性耳鸣均得到改善。
结论：上矢状窦切除术用于乙状窦壁支架置入术是一种安全有效的技术。由于乙状窦壁裂开引起的搏动性耳鸣可以使用血管内表面修复支架技术进行治疗。然而,当检测到静脉狭窄时,需要进一步的研究来评估对侧支架置入术对去除窦口裂开的潜在益处.然而,重修乙状窦壁裂开可改善症状.
