Sigmoid sinus cortical plate dehiscence induces pulsatile tinnitus through amplifying sigmoid sinus venous sound
Sigmoid sinus cortical plate dehiscence induces pulsatile tinnitus through amplifying sigmoid sinus venous sound
复制标题
乙状窦皮质板裂开通过放大乙状窦静脉音诱发搏动性耳鸣
DOI：
10.1016/j.jbiomech.2016.12.012
复制
发表时间：
2017-02-08
影响因子：
2.4
通讯作者：
Fan, Yubo
中科院分区：
文献类型：
--
作者：
Tian, Shan;Wang, Lizhen;Fan, Yubo
乙状窦皮质板裂开(SSCPD)是搏动性耳鸣(PT)患者的常见症状，临床上多采用SSCPD表面术治疗，但其生物学机制尚不清楚。本研究旨在阐明SSCPD诱发PT感觉的生物学机制，并量化皮质板厚度与PT感觉强度的关系。本研究假设SSCPD可通过显着放大乙状窦(SS)静脉音而诱发PT。基于典型患者的放射学数据的有限元(FE)分析被用来验证这一假设，并与临床报告进行了验证。在不同CP厚度的情况下，对SS静脉声的产生和传播过程进行了有限元模拟，包括SS静脉流场、SS上覆组织(包括SS血管壁和CP)的振动响应以及声音在颞骨空气细胞中的传播。结果表明，SSCPD患者鼓膜SS静脉音为56.9dB，正常CP鼓膜SS静脉音为-45.2d B，所有薄型CP患者鼓膜SS静脉音均为阴性。结论：SSCPD可通过显著放大SS静脉音直接诱发PT，薄CP不是PT的唯一病理生理机制。这一结论将为单侧SCPD或薄型CP的PT患者设计SSCPD表面置换术提供理论依据。(C)2017爱思唯尔有限公司。保留所有权利。
Sigmoid sinus cortical plate dehiscence (SSCPD) is common in pulsatile tinnitus (PT) patients, and is treated through SSCPD resurfacing surgery in clinic, but the bio-mechanism is not clear as so far. This study aimed to clarify the bio-mechanism of PT sensation induced by SSCPD, and quantify the relationship of cortical plate (CP) thickness and PT sensation intensity. It was hypothesized that SSCPD would induce PT through significantly amplifying sigmoid sinus (SS) venous sound in this study. Finite element (FE) analysis based on radiology data of typical patient was used to verify this hypothesis, and was validated with clinical reports. In cases with different CP thickness, FE simulations of SS venous sound generation and propagation procedure were performed, involving SS venous flow field, vibration response of tissue overlying dehiscence area (including SS vessel wall and CP) and sound propagation in temporal bone air cells. It was shown in results that SS venous sound at tympanic membrane was 56.9 dB in SSCPD case and -45.2 dB in intact CP case, and was inaudible in all thin CP cases. It was concluded that SSCPD would directly induce PT through significantly amplifying SS venous sound, and thin CP would not be the only pathophysiology of PT. This conclusion would provide a theoretical basis for the design of SSCPD resurfacing surgery for PT patients with SSCPD or thin CP. (C) 2017 Elsevier Ltd. All rights reserved.