Diagnosis and Interventional Therapy of Pulsatile Tinnitus Caused by Vascular

LI Baomin; CAO Xiangyu; LIU Xinfeng; LI Sheng; WANG Jun; LIANG Yongping; GE Aili; ZHANG Alan; FENG Huimin

doi:10.3969/j.issn.1672-2922.2014.02.02

Abstract：Objective To retrospective evaluate the imaging diagnosis and disease characteristics of pulsatile tinnitus caused by vascular, and to estimate the feasibility and clinical effect of interventional therapy. Methods The DSA characteris-tic and pathophysiological mechanisms of 82 cases pulsatile tinnitus caused by cerebral artery and venous sinus were ana-lyzed retrospectively. All the patients were treated by interventional therapy via femoral artery and venous with coil、NBCA glue、balt Balloon、self-expandable stent and intracranial micro-stent. The patients included 3 cases intracranial AVF、16 cas-es spontaneous skull base DAVF、5 cases TCCF、2 cases subclavian artery stenosis、3 cases internal carotid artery stenosis ,1 case intracranial artery stenosis、2 case vertebrobasilar artery circuity and extension、2 cases venous sinus diverticulum、46 cases venous sinus stenosis in drainage dominancy side、2 cases occipital sinus stenosis. Result Pulsatile tinnitus disap-peared in two days following the procedure in all 82 cases. There was not procedure related complication. During the 5 to 36 months follow-up, 5 cases pulsatile tinnitus caused by cerebral artery had recurrence 3 months after operation . The pulsatile tinnitus of 5 patients disappeared after secondly embolizaiton. The pulsatile tinnitus caused by venous sinus treated by stent and stent-assisted embolization had not recurrence. Conclusion Endovascular therapy could provide a new way for diagnosis and cure of stubborn pulsatile tinnitus, and endovascular therapy could provide theoretical and technical evidence for diagno-sis and study of other types of tinnitus.