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

TitleResolution of Pulsatile Tinnitus after Venous Sinus Stenting in Patients with Idiopathic Intracranial Hypertension.
Publication TypeJournal Article
Year of Publication2016
AuthorsBoddu S, Dinkin M, Suurna M, Hannsgen K, Bui X, Patsalides A
JournalPLoS One
Volume11
Issue10
Paginatione0164466
Date Published2016
ISSN1932-6203
KeywordsAdolescent, Adult, Body Mass Index, Cranial Sinuses, Female, Humans, Intracranial Hypertension, Male, Middle Aged, Prospective Studies, Stents, Tinnitus, Young Adult
Abstract

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.

SUBJECTS AND 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).

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

DOI10.1371/journal.pone.0164466
Alternate JournalPLoS ONE
PubMed ID27768690
PubMed Central IDPMC5074492