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Causes and outcomes of revision surgery in subjects with pulsatile tinnitus
INTRODUCTION: Once the underlying pathology has been identified, pulsatile tinnitus (PT) can be treated successfully with surgical or interventional management. However, some patients experience residual or recurrent symptoms following initially successful surgical treatment, and require revision su...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405522/ https://www.ncbi.nlm.nih.gov/pubmed/37554389 http://dx.doi.org/10.3389/fneur.2023.1215636 |
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author | Shim, Ye Ji Lee, Hanju Park, Sung-Min Kim, Dohee Koo, Ja-Won Song, Jae-Jin |
author_facet | Shim, Ye Ji Lee, Hanju Park, Sung-Min Kim, Dohee Koo, Ja-Won Song, Jae-Jin |
author_sort | Shim, Ye Ji |
collection | PubMed |
description | INTRODUCTION: Once the underlying pathology has been identified, pulsatile tinnitus (PT) can be treated successfully with surgical or interventional management. However, some patients experience residual or recurrent symptoms following initially successful surgical treatment, and require revision surgery or additional procedures. Here, we report a case series of patients who had undergone revision surgery or interventional treatment, and suggest possible ways of minimizing the need for revision. METHODS: Between January 2014 and March 2023, a total of seven subjects underwent revision surgery or interventional treatment for persistent or recurrent PT after initial surgical treatment. Demographic data, reasons for revision, and changes in symptoms before and after revision were analyzed retrospectively. Temporal bone computed tomographic angiography images were reviewed to identify the causes and reasons for revision. RESULTS: Of the seven subjects, six underwent sigmoid sinus (SS) resurfacing/reshaping due to ipsilateral diverticulum (Div) or dehiscence (Deh), and one underwent jugular bulb (JB) resurfacing due to a high-riding JB with bony Deh. Of the five subjects who underwent revision SS surgery due to recurrent SS-Div or SS-Deh, three showed marked resolution of PT, while the other two showed partial improvement of the symptoms. One subject who underwent revision JB resurfacing, and another who underwent additional transarterial embolization for a concurrent ipsilateral dural arteriovenous fistula, reported marked improvement of PT. DISCUSSION: The possibility of recurrence should be taken into account when performing surgical intervention in patients with PT. The likelihood of recurrence can be minimized through a comprehensive evaluation to identify possible multiple etiologies, and through the use of durable materials and appropriate surgical methods. |
format | Online Article Text |
id | pubmed-10405522 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104055222023-08-08 Causes and outcomes of revision surgery in subjects with pulsatile tinnitus Shim, Ye Ji Lee, Hanju Park, Sung-Min Kim, Dohee Koo, Ja-Won Song, Jae-Jin Front Neurol Neurology INTRODUCTION: Once the underlying pathology has been identified, pulsatile tinnitus (PT) can be treated successfully with surgical or interventional management. However, some patients experience residual or recurrent symptoms following initially successful surgical treatment, and require revision surgery or additional procedures. Here, we report a case series of patients who had undergone revision surgery or interventional treatment, and suggest possible ways of minimizing the need for revision. METHODS: Between January 2014 and March 2023, a total of seven subjects underwent revision surgery or interventional treatment for persistent or recurrent PT after initial surgical treatment. Demographic data, reasons for revision, and changes in symptoms before and after revision were analyzed retrospectively. Temporal bone computed tomographic angiography images were reviewed to identify the causes and reasons for revision. RESULTS: Of the seven subjects, six underwent sigmoid sinus (SS) resurfacing/reshaping due to ipsilateral diverticulum (Div) or dehiscence (Deh), and one underwent jugular bulb (JB) resurfacing due to a high-riding JB with bony Deh. Of the five subjects who underwent revision SS surgery due to recurrent SS-Div or SS-Deh, three showed marked resolution of PT, while the other two showed partial improvement of the symptoms. One subject who underwent revision JB resurfacing, and another who underwent additional transarterial embolization for a concurrent ipsilateral dural arteriovenous fistula, reported marked improvement of PT. DISCUSSION: The possibility of recurrence should be taken into account when performing surgical intervention in patients with PT. The likelihood of recurrence can be minimized through a comprehensive evaluation to identify possible multiple etiologies, and through the use of durable materials and appropriate surgical methods. Frontiers Media S.A. 2023-07-24 /pmc/articles/PMC10405522/ /pubmed/37554389 http://dx.doi.org/10.3389/fneur.2023.1215636 Text en Copyright © 2023 Shim, Lee, Park, Kim, Koo and Song. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Shim, Ye Ji Lee, Hanju Park, Sung-Min Kim, Dohee Koo, Ja-Won Song, Jae-Jin Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title | Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title_full | Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title_fullStr | Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title_full_unstemmed | Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title_short | Causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
title_sort | causes and outcomes of revision surgery in subjects with pulsatile tinnitus |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405522/ https://www.ncbi.nlm.nih.gov/pubmed/37554389 http://dx.doi.org/10.3389/fneur.2023.1215636 |
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