颈静脉球憩室的栓塞治疗在搏动性耳鸣管理中的应用
Embolization of jugular bulb diverticula in the management of pulsatile tinnitus.
文献信息
| PMID | 42922877 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Timothy White |
| 作者单位 | Northwell Health, New Hyde Park, NY, United States. |
| 期刊 | Frontiers in neurology |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
引言： 由高位颈静脉球或显著憩室引起的搏动性耳鸣（PT）会对生活质量产生负面影响。本研究评估血管内治疗（包括支架置入、弹簧圈栓塞和Woven EndoBridge（WEB；Terumo Neuro，Aliso Viejo，CA）装置）治疗颈静脉球憩室（JBD）所致PT的有效性。
方法： 进行了一项回顾性综述，时间范围为2020年9月1日至2026年4月30日，共识别出12例诊断为JBD的患者。提取的数据包括人口统计学资料、PT特征、治疗细节和结局。在深入检查（通常包括球囊闭塞试验）后实施血管内干预。描述了各种干预措施的结局和技术。
结果： 12例患者（8例女性、4例男性）因JBD接受血管内治疗，中位年龄为40.5岁，中位BMI为25.8 kg/m2。球囊闭塞试验（BTO）显示7/8例患者（87.5%）至少有中度改善。11例（91.7%）实施了针对JBD的支架辅助弹簧圈栓塞，1例患者成功置入WEB。有两次置入WEB装置的尝试未成功，治疗转为支架辅助弹簧圈栓塞。在平均7.25个月的最后随访时，9例患者（75%）症状完全缓解，3例（25%）症状显著改善（25%）。
结论： 血管内干预对于治疗JBD相关PT安全且有效。BTO是一项重要的术中工具，可能有助于预测治疗成功。有必要进一步研究最佳患者选择以及特定装置在治疗JBD中的作用。
英文摘要
INTRODUCTION: Pulsatile tinnitus (PT) caused by a high riding jugular bulb or prominent diverticulum can negatively impact quality of life. This study evaluates the effectiveness of endovascular treatments, including stenting, coiling, and Woven EndoBridge (WEB; Terumo Neuro, Aliso Viejo, CA) devices, for managing jugular bulb diverticula (JBD)-induced PT.
METHODS: A retrospective review was conducted from September 1, 2020 to April 30, 2026, identifying twelve patients diagnosed with JBD. Data extracted included demographics, PT characteristics, treatment details, and outcomes. Endovascular interventions were pursued after in depth work-up, often including balloon test occlusion. The outcomes and techniques of various interventions are described.
RESULTS: Twelve patients (eight females and four males) underwent endovascular treatment for JBD, with a median age of 40.5 years and a median BMI of 25.8 kg/m2. Balloon-test occlusion (BTO) showed at least moderate improvement in 7/8 patients (87.5%). Stent-assisted coiling for the JBD was performed in eleven cases (91.7%), and placement of a WEB was successful in one patient. There were two unsuccessful attempts in placing a WEB device, and treatment was converted to stent-assisted coiling. At an average last follow-up of 7.25 months, nine patients (75%) had complete resolution and three (25%) had significant improvement (25%) of their symptoms.
CONCLUSION: Endovascular interventions are safe and effective for treating JBD-related PT. BTO is an important intraprocedural tool that may help predict treatment success. Further investigation into optimal patient selection and the role of specific devices in treating JBD is warranted.