Resolution of Pulsatile Tinnitus after Venous Sinus Stenting in Patients with Idiopathic Intracranial Hypertension

PLoS One

Kelly Hannsgen¹  Athos Patsalides¹  Srikanth Boddu¹  Xem Bui¹  Marc Dinkin²  Maria Suurna³ 

[1] Department of Neurological surgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital / Weill Cornell Medical Center, New York, New York, United States of America;Department of Ophthalmology, New York Presbyterian Hospital / Weill Cornell Medical Center, New York, New York, United States of America;Department of Otolaryngology, New York Presbyterian Hospital / Weill Cornell Medical Center, New York, New York, United States of America

关键词: Tinnitus;    Stenosis;    Stent implantation;    Body mass index;    Headaches;    Obesity;    Hypertension;    Jugular vein;   

DOI  :  10.1371/journal.pone.0164466

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Objective Evaluate the role of venous sinus stenting in the treatment of pulsatile tinnitus among patients with Idiopathic Intracranial Hypertension (IIH) and significant venous sinus stenosis. Subjects and Methods A written informed consent approved by the Weill Cornell institutional review board was signed and obtained from the study participants. Thirty-seven consecutive patients with IIH and venous sinus stenosis who were treated with venous sinus stenting between Jan.2012-Jan.2016 were prospectively evaluated. Patients without pulsatile tinnitus were excluded. Tinnitus severity was categorized based on “Tinnitus Handicap Inventory” (THI) at pre-stent, day-0, 1-month, 3-month, 6-month, 12-month, 18-month and 2-year follow-up. Demographics, body-mass index (BMI), pre and post VSS trans-stenotic pressure gradient were documented. Statistical analysis performed using Pearson’s correlation, Chi-square analysis and Fischer’s exact test. Results 29 patients with a mean age of 29.5±8.5 years M:F = 1:28. Median (mean) THI pre and post stenting were: 4 (3.7) and 1 (1) respectively. Median time of tinnitus resolution post VSS was 0-days. There was significant improvement of THI (Δ Mean: 2.7 THI [95% CI: 2.3–3.1 THI], p<0.001) and transverse-distal sigmoid sinus gradient (Δ Mean: -15.3 mm Hg [95% CI: 12.7–18 mm Hg], p<0.001) post-stenting. Mean follow-up duration of 26.4±9.8 months (3–44 months). VSS was feasible in 100% patients with no procedural complications. Three-patients (10%) had recurrent sinus stenosis and tinnitus at mean follow-up of 12 months (6–30 months). Conclusion Venous sinus stenting is an effective treatment for pulsatile tinnitus in patients with IIH and venous sinus stenosis.

【 授权许可】

CC BY