Endovascular vs surgical treatment of sigmoid sinus diverticulum causing pulsatile tinnitus: A systematic review.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Interventional Neuroradiology Pub Date : 2024-03-22 DOI:10.1177/15910199241231325

Anvitha Sathya, Thanh N Nguyen, Piers Klein, Stephanos Finitsis, Bindu N Setty, Adam A Dmytriw, Kyle M Fargen, Ferdinand K Hui, Peter Weber, Matthew R Amans, Mohamad Abdalkader

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Abstract

Introduction: Sigmoid sinus diverticulum (SSD) has been increasingly reported as a cause of pulsatile tinnitus (PT). While both endovascular and surgical treatments have been used, there is a lack of consensus on the treatment modality to treat SSD. We conducted a systematic review of the available literature to compare the clinical outcomes and safety of endovascular versus surgical approaches for treating SSD.

Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify studies encompassing the management of SSD. Studies reporting the clinical outcomes and safety of endovascular or surgical treatments for SSD between January 2000 and January 2023 were included. Results were characterized using descriptive statistics.

Results: Endovascular treatment (EVT) was reported by 17 articles, yielding 26 patients with 27 diverticula. Surgical treatment was reported by 20 articles, yielding 105 patients with 107 diverticula. EVT led to complete or near-complete resolution in all patients with SSD and PT. Complications occurred in 3.7% (1/27) with a return to baseline after 2 months. There were no permanent complications from EVT. Surgical treatment resulted in complete resolution in 77.6% (83/107) of cases, incomplete resolution in 11.2% (12/107), and no resolution in 11.2% (12/107). Significant complications occurred in 9.3% (10/107) of the surgical-treated patients.

Conclusion: EVT in patients with PT and venous diverticulum appears more effective and safer than surgical treatment, but large studies are lacking. Studies directly comparing endovascular and surgical treatment are needed.

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引起搏动性耳鸣的乙状窦憩室的血管内治疗与手术治疗：系统综述。

导言：越来越多的报道称乙状窦憩室 (SSD) 是导致搏动性耳鸣 (PT) 的原因之一。虽然血管内治疗和手术治疗均已使用，但对于治疗 SSD 的治疗方式还缺乏共识。我们对现有文献进行了系统性回顾，比较了血管内治疗与手术治疗 SSD 的临床效果和安全性：方法：我们根据《系统综述和元分析首选报告项目》进行了系统综述，以确定有关 SSD 治疗的研究。研究纳入了 2000 年 1 月至 2023 年 1 月期间报告 SSD 的血管内治疗或手术治疗的临床结果和安全性的研究。研究结果采用描述性统计：结果：17 篇文章报道了血管内治疗（EVT），共治疗了 26 名患者，27 个憩室。20篇文章报道了手术治疗，共有105名患者，107个憩室。所有 SSD 和 PT 患者的 EVT 治疗均可完全或接近完全治愈。3.7%的患者（1/27）出现并发症，2个月后恢复到基线水平。EVT治疗未出现永久性并发症。手术治疗的结果是，77.6%（83/107）的病例完全缓解，11.2%（12/107）的病例不完全缓解，11.2%（12/107）的病例没有缓解。9.3%（10/107）的手术治疗患者出现了严重并发症：结论：EVT治疗PT合并静脉憩室患者似乎比手术治疗更有效、更安全，但目前还缺乏大规模的研究。结论：EVT 对 PT 和静脉憩室患者的治疗似乎比手术治疗更有效、更安全，但目前还缺乏大型研究，需要对血管内治疗和手术治疗进行直接比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...