Resolution of Pulsatile Tinnitus after Venous Sinus Stenting in Patients with Idiopathic Intracranial Hypertension. 2016

Srikanth Boddu, and Marc Dinkin, and Maria Suurna, and Kelly Hannsgen, and Xem Bui, and Athos Patsalides
Department of Neurological surgery, Division of Interventional Neuroradiology, New York Presbyterian Hospital / Weill Cornell Medical Center, New York, New York, United States of America.

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. 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). CONCLUSIONS Venous sinus stenting is an effective treatment for pulsatile tinnitus in patients with IIH and venous sinus stenosis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003392 Cranial Sinuses Large endothelium-lined venous channels situated between the two layers of DURA MATER, the endosteal and the meningeal layers. They are devoid of valves and are parts of the venous system of dura mater. Major cranial sinuses include a postero-superior group (such as superior sagittal, inferior sagittal, straight, transverse, and occipital) and an antero-inferior group (such as cavernous, petrosal, and basilar plexus). Cranial Venous Sinuses,Intracranial Sinuses,Sinuses, Cranial,Sinuses, Cranial Venous,Sinuses, Intracranial,Venous Sinuses, Cranial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014012 Tinnitus A nonspecific symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of COCHLEAR DISEASES; VESTIBULOCOCHLEAR NERVE DISEASES; INTRACRANIAL HYPERTENSION; CRANIOCEREBRAL TRAUMA; and other conditions. Pulsatile Tinnitus,Ringing-Buzzing-Tinnitus,Spontaneous Oto-Acoustic Emission Tinnitus,Tensor Palatini Induced Tinnitus,Tensor Tympani Induced Tinnitus,Tinnitus of Vascular Origin,Tinnitus, Clicking,Tinnitus, Leudet,Tinnitus, Leudet's,Tinnitus, Noise Induced,Tinnitus, Objective,Tinnitus, Spontaneous Oto-Acoustic Emission,Tinnitus, Subjective,Tinnitus, Tensor Palatini Induced,Tinnitus, Tensor Tympani Induced,Vascular Origin Tinnitus,Clicking Tinnitus,Induced Tinnitus, Noise,Leudet Tinnitus,Leudet's Tinnitus,Noise Induced Tinnitus,Objective Tinnitus,Ringing Buzzing Tinnitus,Spontaneous Oto Acoustic Emission Tinnitus,Subjective Tinnitus,Tinnitus, Leudets,Tinnitus, Pulsatile,Tinnitus, Spontaneous Oto Acoustic Emission,Tinnitus, Vascular Origin
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent

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