目的:比较搏动性耳鸣(PT)患者与对照组患者乙状窦壁异常(SSWAs)和其他影像学异常的发生率。
方法:回顾性病例对照。
方法:三级转诊中心。
方法:将接受PT和高分辨率计算机断层扫描成像的成年人与接受人工耳蜗检查(包括高分辨率计算机断层扫描成像)的成年人进行比较。
方法:与对照组(n=149,n=298耳)相比,PT队列(n=141)中SSWA的发生率。次要结果指标包括队列之间的人口统计学和其他放射学异常的差异。
结果:PT患者的SSWA发生率较高(34%对9%,p<0.001)和上管开裂(23%对12%,p=0.017)比对照组。Spearman乘积成分相关性表明,同侧PT与SSWA弱相关(r=0.354,p<0.001)。当PT队列中存在SSWA时(n=48例患者,n=59耳),31例(64.6%),SSWA与PT侧向性相关(例如,左SSWA,左PT);在12(25.0%)中,SSWA与PT侧向性部分相关(例如,双边SSWA,右PT);在5(10.4%)中,SSWA与PT侧向性不相关(例如,右SSWA,左PT)。
结论:对于我们的PT和SSWA患者,在大约65%的病例中,SSWA可能是一个促成因素.对于三分之一的PT和SSWA患者,两者之间的联系要么不是因果关系,要么不仅仅是因果关系。为PT和SSWA患者提供咨询的外科医生总体上对乙状结肠表面置换术持乐观态度,但必须意识到治疗失败的可能性。可能是因为未经处理的合并症。
Compare incidence of sigmoid sinus wall abnormalities (SSWAs) and other radiographic abnormalities in patients with pulsatile tinnitus (PT) versus controls.
Retrospective
case-control.
Tertiary referral center.
Adults with PT and high-resolution computed tomography imaging were compared with adults undergoing cochlear implant workup including high-resolution computed tomography imaging.
Incidence of SSWA in PT cohort (n = 141) compared with control (n = 149, n = 298 ears). Secondary outcome measures included differences in demographics and in other radiographic abnormalities between cohorts.
Patients with PT had a higher incidence of SSWA (34% versus 9%, p < 0.001) and superior canal dehiscence (23% versus 12%, p = 0.017) than controls. Spearman product component correlations demonstrated that ipsilateral PT was weakly associated with SSWA ( r = 0.354, p < 0.001). When SSWA was present in the PT cohort (n = 48 patients, n = 59 ears), in 31 cases (64.6%), the SSWA correlated with PT laterality (e.g., left SSWA, left PT); in 12 (25.0%), SSWA partially correlated with PT laterality (e.g., bilateral SSWA, right PT); and in 5 (10.4%), the SSWA did not correlate with PT laterality (e.g., right SSWA, left PT).
For our patients with both PT and SSWA, the SSWA is likely a contributing factor in approximately 65% of cases. For a third of patients with PT and concomitant SSWA, the association between the two is either not causative or not solely causative. Surgeons counseling patients with PT and SSWA may be optimistic overall regarding sigmoid resurfacing procedures but must appreciate the possibility of treatment failure, likely because of untreated comorbid conditions.