颈静脉球憩室临床特征分析

陈金辉;华清泉;廖华;陈始明;屈季宁;陶泽璋;

1:武汉大学人民医院耳鼻咽喉头颈外科

2:武汉大学人民医院耳鼻咽喉头颈外科

3:武汉大学人民医院耳鼻咽喉头颈外科

4:武汉大学人民医院耳鼻咽喉头颈外科

摘要
目的探讨颈静脉球憩室的临床特征、诊断和治疗。方法对1例颈静脉球憩室患者的临床特征、影像学表现及治疗等临床资料进行分析并复习相关文献。结果该例患者临床表现为双耳渐进性听力下降伴耳鸣,偶发短暂眩晕,纯音测听示双耳混合性聋,双耳鼓室导抗图为C型。轴位CT提示颈静脉孔扩大,周边骨质吸收,边界光滑,颈内动脉垂直段后方骨质缺损,中下鼓室有软组织影。轴位MRI未见明显异常。血管造影证实为颈静脉球憩室。综合文献报道,认为颈静脉球憩室可能没有临床症状,也可能引发耳聋、耳鸣、眩晕、甚至吞咽困难和声嘶等。其诊断和鉴别诊断主要依靠影像学检查。血管造影是确诊颈静脉球憩室的重要依据之一。该病药物治疗效果欠佳。对于引发严重的类梅尼埃症状的颈静脉球憩室患者,可考虑手术治疗。结论颈静脉球憩室的临床表现缺乏特征性,确诊主要依靠影像学检查。
关键词
颈静脉球憩室;耳鸣;听力损失
基金项目(Foundation):
作者
陈金辉;华清泉;廖华;陈始明;屈季宁;陶泽璋;
参考文献

1李玉,樊兆民,巩若箴.颈静脉憩室的临床和CT分析[J].中华耳鼻咽喉头颈外科杂志,2005,40:542.

2El-Kashlan HK,Arts HA,Gebarski S.Jugular diverticu-lum:clinical significans[J].Otolaryngol Head Neck Surg,2000,122:575.

3Koeslinga S,Kunkelb P,Schulb T.Vascular anomalies,su-tures and small canals of the temporal bone on axial CT[J].European Journal of Radiology,2005,54:335.

4Atilla S,Akpek S,Uslu S,et al.Computed tomographic e-valuation of surgically significant vascular variations related with the temporal bone[J].European Journal of Radiology,1995,20:52.

5Jahrsdoerfer RA,Cail WS,Cantrell RW.Endolymphatic duct obstruction from a jugular bulb diverticulum[J].Ann Otol Rhionl Laryngol,1981,90:619.

6Walter Kutz JRJ,Cruz AD.The jugular bulb diverticulum[J].Ear,nose&Throat Journal,2007,86:130.

7Kobanawa S,Atsuchi M,Tanaka J,et al.Bulb Diverticulum Associated with Lower Cranial Nerve Palsy and Multiple An-eurysms[J].Surg Neurol,2000,53:559.

8Wadin K,Thomander L,Wilbrand H.Effects of a highjugu-lar fossa and jugular bulb diverticulum on the inner ear[J].Acta Radiologica Diagnosis,1986,27:629.

9Bozorg Grayeli A,Bouccara D,Julien N,et al.Surgical treat-ment of vertigo induced by jugular bulb diverticulum[J].Rev Laryngol Otol Rhinol(Bord),1995,116:31.