Study on the classification of symptomatic tinnitus caused by head and neck venous stenosis based on CT venography
Objective To investigate the classification and clinical characteristics among different types of symptomatic tinnitus caused by head and neck venous stenosis based on CT venography(CTV).Methods From September 2020 to December 2022,a total of 43 patients were diagnosed as head and neck venous stenosis based on CTV imaging at Beijing Shijitan Hospital,Capital Medical University.All patients had tinnitus as the main symptom.According to CTV imaging,venous stenosis of the head and neck was divided into intracranial venous sinus type,internal jugular vein type and composite type(intracranial venous sinus-internal jugular vein combined stenosis type).Differences in the imaging demonstrations and some clinical characteristics of the patients with those 3 types were retrospectively analyzed.Results Among the 43 patients,14(32.6％)belonged to the intracranial venous sinus type,of which 10 cases had stenosis located in the transverse sinus,caused by arachnoid granule hyperplasia and compression;4 cases had linear stenosis at the transition between the confluence of sinuses and the transverse sinus.There were 16 cases(37.2％)of internal jugular vein type,and the stenosis was all located in the transverse process segment of the atlas.Among them,6 cases were caused by hyperplasia of the transverse process of the atlas and compression stenosis,and 10 cases were caused by the internal jugular vein running between transverse process of the atlas and the styloid process,resulting in local lumen compression and stenosis.There were 13 cases(30.2％)of the composite type.The stenosis was located in the transverse sinus and the transverse process segment of the atlas.Among them,3 cases had stenosis at the confluence of sinuses and the transitional part of the transverse sinus.Ten cases had arachnoid granule hyperplasia compressing the transverse sinus.Among them,3 cases had a single stenosis.The lateral intracranial venous sinuses and internal jugular veins were small throughout.The proportion of female patients with intracranial sinus type was higher than that of internal jugular vein type and composite type,and the disease duration was shorter than that of internal jugular vein type and composite type(all P＜0.05).There were no statistically significant differences in age and side of stenosis among patients with the three types of classification(all P＞0.05).Conclusions Based on CTV,the three types of symptomatic tinnitus caused by head and neck venous stenosis have similar composition ratios,among which arachnoid granule compression is a common cause of intracranial sinus stenosis and bone hyperplasia compression is a common cause of internal jugular vein type.In some patients,the stenosis may be related to congenital developmental factors.The clinical characteristics of the three types of head and neck venous stenosis may be different.
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