Angioplasty and Stenting for Intractable Pulsatile Tinnitus Caused by Dural Venous Sinus Stenosis

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Abstract

Pulsatile tinnitus caused by dural venous sinus (DVS) stenosis is a newly identified form of tinnitus. Its persistent nature can severely affect patients' sleep and quality of life, leading to depression in severe cases. The aim of this report is to investigate the efficacy and safety of angioplasty and stenting in treating this form of tinnitus.

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Most cited references 18

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Classification and epidemiology of tinnitus.

Katherine Heller (2003)

One third of all adults report experiencing tinnitus at some time in their lives. Ten percent to 15% have prolonged tinnitus requiring medical evaluation. Classification of tinnitus requires a thorough history and physical examination, supplemented by appropriate diagnostic tests. Tinnitus can be categorized according to its qualities (as described by the patient and matched on the audiometer) and its clinical type (as suggested by probable etiology). Audiologic testing, tinnitus analysis, and occasional radiologic studies assist with classification and direction of treatment planning. The THI is another method of classification that can facilitate the precise monitoring of a patient's progress. By using these tools and standardizing the language, tinnitus studies around the world can become more comparable and patients can be better monitored for treatment response.

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Early versus late injection medialization for unilateral vocal cord paralysis.

T Heaton, Steven Zeitels, Alan Friedman … (2010)

To evaluate whether the timing of early (≤6 months from time of nerve injury) vs. late (>6 months) injection medialization laryngoplasty impacts the need for subsequent open-neck reconstruction to restore vocal function in patients with unilateral vocal cord paralysis. Retrospective chart review. A total of 112 outpatient or hospitalized adults with dysphonia resulting from postsurgical or idiopathic unilateral vocal cord paralysis were identified who were injected as initial treatment within 1 year of onset of their paralysis. All subjects underwent awake, transoral, paraglottic injection with absorbable hyaluronic-acid gel. Patients with documented recovery of vocal cord mobility (22), active disease directly affecting the recurrent laryngeal nerve (8), 6 months postparalysis) avoided phonosurgical reconstruction (P = .03, χ2 test). Patients receiving early injection medialization for vocal cord paralysis were less likely to require transcervical reconstruction. We believe that early medialization creates a more favorable vocal cord position for phonation that can be maintained by synkinetic reinnervation, in contrast to the final position of a lateralized vocal cord being determined solely by reinnervation.

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Imaging in pulsatile tinnitus.

G Madani, S Connor (2009)

Tinnitus may be continuous or pulsatile. Vascular lesions are the most frequent radiologically demonstrable cause of pulsatile tinnitus. These include congenital vascular anomalies (which may be arterial or venous), vascular tumours, and a variety of acquired vasculopathies. The choice of imaging depends on the clinical findings. If a mass is present at otoscopy, thin-section computed tomography (CT) is indicated. In the otoscopically normal patient, there is a range of possible imaging approaches. However, combined CT angiography and venography is particularly useful.