OBJECTIVETo discuss the diagnosis and management of venous original pulsatile tinnitus associated with sigmoid sinus.

METHODSA retrospective study was conducted on 12 patients who were diagnosed with venous original pulsatile tinnitus associated with sigmoid sinus, and treated with sigmoid sinus constriction surgery. The diagnostic evidences for venous original pulsatile tinnitus associated with sigmoid sinus were re-evaluated, the pulsatile tinnitus improvements and MRV study results before and after surgeries associated with sigmoid sinus were compared.

RESULTSEleven patients got relief of tinnitus within three months after the surgeries, while one patient had no relief. There were ten patients underwent MRV study, the cross-sectional area of the sigmoid sinus in the healthy side was about two times in the tinnitus side. Constriction sigmoid sinus was performed on the twelve patients. The cross-sectional area of the sigmoid sinus of relieved tinnitus patients were compressed by forty-six percent to eighty-three percent. None of the cases complained of any serious complications.

CONCLUSIONSSigmoid sinus constriction is an available therapy for pulsatile tinnitus at present. More cases and longer follow-up are necessary to evaluate its treatment effect accurately.

Constriction ; Cranial Sinuses ; surgery ; Humans ; Retrospective Studies ; Tinnitus ; diagnosis ; surgery

Cranial Sinuses ; surgery ; Diverticulum ; complications ; surgery ; Humans ; Male ; Middle Aged ; Tinnitus ; etiology ; surgery

PURPOSE: Tinnitus is a very common symptom of vestibular schwannoma, present in 45 to 80% of patients. We evaluated changes in tinnitus after translabyrinthine microsurgery (TLM) or gamma knife radiosurgery (GKS). MATERIALS AND METHODS: Among 78 patients with vestibular schwannoma who underwent TLM or GKS at Severance Hospital from 2009-2012, 46 patients with pre- or postoperative tinnitus who agreed to participate were enrolled. Pure tone audiometry, tinnitus handicap inventory (THI), visual analogue scale (VAS) scores for loudness, awareness, and annoyance were measured before and after treatment. Changes of THI and VAS were analysed and compared according to treatment modality, tumour volume, and preoperative residual hearing. RESULTS: In the TLM group (n=27), vestibulocochlear nerves were definitely cut. There was a higher rate of tinnitus improvement in TLM group (52%) than GKS group (16%, p=0.016). The GKS group had a significantly higher rate of tinnitus worsening (74%) than TLM group (11%, p<0.001). Mean scores of THI and VAS scores significantly decreased in the TLM group in contrast to significant increases in the GKS group. Tumor volume and preoperative hearing did not affect the changes in THI or VAS. CONCLUSION: GKS can save vestibulocochlear nerve continuity but may damage the cochlea, cochlear nerve and can cause worsening tinnitus. In cases where hearing preservation is not intended, microsurgery with vestibulocochlear neurectomy during tumor removal can sometimes relieve or prevent tinnitus.
Adult ; Female ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic/*surgery ; Radiosurgery/*methods ; Tinnitus/*surgery ; Treatment Outcome

Cochlear Implantation ; Cochlear Implants/adverse effects* ; Hearing Loss, Sensorineural/surgery* ; Humans ; Tinnitus/surgery* ; Treatment Outcome

OBJECTIVE: To discuss the diagnosis and management of pulsatile tinnitus of venous origin. METHOD: A retrospective study was conducted on 12 patients who were diagnosed with pulsatile tinnitus of venous origin and treated with ligation of internal jugular veins. We reevaluated the evidences of identifying pulsatile tinnitus of venous origin and reviewed the short-term and long-term postoperative effects and complications. We also reviewed associated articles in this report. RESULT: Seven patients got relief of tinnitus in less than one week after the surgery, while the other 5 patients had no relief. Seven patients were inquired in this study and the other five lost to follow-up. According to the long review (from one to five years postoperatively), two patients who acquired immediate effect got relief of tinnitus, four including complained of no relief and the seventh aggravated into roaring. Three patients who got no immediate relief got no improvement at all. No one in our review complained of any complications. CONCLUSION It's assumed that a history of pulsatile tinnitus, alleviation of tinnitus when pressing jugular veins, tinnitus changing with head position or posture and no occupying lesion in temporal CT scan or cranial MRI are inadequate in diagnosing pulsatile tinnitus of venous origin. Vascular imaging is also necessary to exclude other pathological changes like dura arteriovenous fistula, sigmoid diverticulum and so on. CT arteriography and venography are recommended preferentially. Ligation of internal jugular veins is controversial in patients who have no absence of transverse and sigmoid sinus and identified as pulsatile tinnitus of venous origin.
Adult ; Female ; Humans ; Jugular Veins ; surgery ; Middle Aged ; Retrospective Studies ; Tinnitus ; diagnosis ; surgery ; Vascular Surgical Procedures

Patients with patulous Eustachian tubes(PET) usually suffer from annoying symptoms, such as tinnitus, autophony and aural fullness, due to the excessive opening of the Eustachian tube. There is no uniform standard of treatment, and conservative therapy combined with"Stepup"surgical intervention strategy is the main treatment. In this article, we reviewed various surgical treatments of patulous Eustachian tube in recent years, including key points of surgical operation, effectiveness, safety and complications. Full communication and evaluation are needed to establish appropriate patients' expectations preoperatively. A "Stepup" treatment strategy will be carried out, including conservative treatment, tympanic membrane surgery, Eustachian tube pharyngeal orifice constriction surgery, Eustachian tube tympanic orifice plug surgery and Eustachian tube muscle surgery, which aims to maintain normal Eustachian tube function and good middle ear ventilation.
Humans ; Eustachian Tube/surgery* ; Ear Diseases/diagnosis* ; Ear, Middle ; Tympanic Membrane/surgery* ; Tinnitus ; Otitis Media

Initially described in 1929, Warthin's tumor is a benign neoplasm predominantly found in the parotid gland of the salivary glands. Warthin's tumor is synonymous for cystadenoma lymphomatosum, adenolymphoma, and cystadenolymphoma. This tumor usually causes minimal pain, but the patient may complain of tinnitus, pain in the ear, or deafness. The tumor is treated with surgical excision, which is easily performed due to the superficial location of the tumor. In our case, a 69-year-old man visited our clinic primarily complaining of swelling in the left parotid gland area. Computed tomography revealed well-defined margins of the tumor in the superficial lobe of the left parotid gland and heterogeneous contrast enhancement. We performed superficial parotidectomy, with the pathological examination confirming Warthin's tumor. We report a typical case of Warthin's tumor and a literature review.
Adenolymphoma ; Cystadenoma ; Deafness ; Ear ; Humans ; Parotid Gland ; Salivary Glands ; Surgery, Oral ; Tinnitus

Adult ; Female ; Humans ; Male ; Middle Aged ; Tinnitus ; etiology ; surgery ; Young Adult

OBJECTIVEThe aim of the study was to evaluate the effects of cochlear implantation on bilateral perceived tinnitus of postlingually deafened patients.

METHODTotal of 32 postlingually deafened cochlear implant recipients (13 males, 19 females; 31 unilateral,1 bilateral cochlear implantation) with bilateral tinnitus were assessed by Tinnitus Handicap Inventory (THI) before and after implantation. Furthermore, characteristics information of tinnitus were recorded to analyze the variety of tinnitus. Intensity of tinnitus in ispilateral and contralateral ears was investigated when cochlear implant was switched on and off. Statistical analysis was performed by SPSS 18.0.

RESULTSTwenty-two patients (71.0%) got a decreased THI score of more than 20 points after the operation. The average THI score of pre-operation was 56.4±18.1, and post-operation score was 24.7±22.7. A paired-samples t test analysis showed a significant difference of the THI total scores (t=8.037, P<0.05). Tinnitus in the ipsilateral ear improved in 81.9% (27/33) patients and 18.2% (6/33) unchanged. Tinnitus in the contralateral ear improved in 71.0% (22/31) patients, 16.1% (5/31) unchanged and 12.9% (4/31) worsen. Tinnitus of ipsilateral ears improved or abolished in 97.0% (32/33) patients, while 83.9% (26/31) of contralateral ear got reduction or absence of loudness when cochlear implant was switched on.

CONCLUSIONSAs an electrical stimulation treatment method, cochlear implant has the inhibitory effect on tinnitus. However, cases of tinnitus aggravation were found, further data is still necessary before considering CI as a treatment of tinnitus.

Cochlear Implantation ; Cochlear Implants ; Electric Stimulation ; Female ; Humans ; Male ; Perception ; Postoperative Period ; Tinnitus ; surgery

Cerebral Veins ; Female ; Humans ; Middle Aged ; Prosthesis Implantation ; Stents ; Tinnitus ; etiology ; surgery