Jugular Bulb Resurfacing With Bone Cement for Patients With High Dehiscent Jugular Bulb and Ipsilateral Pulsatile Tinnitus
| Autor: | Byung Yoon Choi, Sung Joon Park, Ja Won Koo, Sang Yeon Lee, Seul Ki Song, Jae Jin Song, Han Gyeol Park |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Dehiscence Asymptomatic Tinnitus 03 medical and health sciences Postoperative Complications 0302 clinical medicine Pulsatile Tinnitus Temporal bone medicine Humans 030223 otorhinolaryngology Retrospective Studies business.industry Bone Cements Retrospective cohort study Middle Aged Plastic Surgery Procedures Bone cement Sensory Systems Surgery Treatment Outcome Otorhinolaryngology Jugular bulb Female Neurology (clinical) Jugular Veins medicine.symptom business 030217 neurology & neurosurgery Case series |
| Zdroj: | Otology & Neurotology. 40:192-199 |
| ISSN: | 1537-4505 1531-7129 |
| DOI: | 10.1097/mao.0000000000002093 |
| Popis: | Objective To discuss the possible pathophysiologic mechanism of pulsatile tinnitus (PT) perception due to high jugular bulb with bony dehiscence (HJBD) and its improvement after the dehiscent jugular bulb (JB) resurfacing using bone cement, and to describe the efficacy of an objective measure of PT using transcanal sound recording and spectro-temporal analysis (TSR/STA). Study design Retrospective case series study. Setting A university-based, tertiary care cancer center. Patients Three PT patients with HJBD. Main outcome measure(s) All patients underwent transtympanic resurfacing after the source of PT was confirmed by temporal bone imaging and TSR/STA. Improvement of symptom and the changes in the TSR/STA were analyzed. Results In the first case, a revision operation was performed due to slightly improved but persistent PT after initial resurfacing with bone pate and a piece of conchal cartilage. Revision transtympanic JB resurfacing was performed in this case using bone cement, and PT resolved immediately after the surgery. In the second and third cases, PT resolved completely, or was much abated, immediately after transtympanic resurfacing with bone cement. The TSR/STA also revealed improvement of PT. The median follow-up duration was 28 months, and all three patients remained asymptomatic or much improved compared with their preoperative status. Conclusions Transtympanic resurfacing with bone cement, reinforcing the dehiscent JB to reduce focal turbulent flow, is a simple and effective surgical treatment option in patients with PT due to HJBD. In patients with HJBD, the objective measurement of PT by TSR/STA may be of help in selecting appropriate surgical candidates and objective evaluation of the treatment outcome. |
| Databáze: | OpenAIRE |
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