乙状窦源性耳鸣机制与诊疗研究进展

张玉婷; 郑昱晓; 刘思远; 靳琛; 李彦仕; 左汶奇

doi:10.3969/j.issn.1672-4933.2026.05.014

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乙状窦源性耳鸣机制与诊疗研究进展

综述 | 更新时间：2026-10-08

- 乙状窦源性耳鸣机制与诊疗研究进展
- Advances in Mechanisms, Diagnosis and Treatment of Sigmoid Sinus Associated Pulsatile Tinnitus
- 中国听力语言康复科学杂志 2026年24卷第5期页码：524-529
- 作者机构：
  
  重庆医科大学附属第一医院耳鼻咽喉头颈外科重庆 400016
- 作者简介：
  
  张玉婷硕士在读；研究方向：听力学
  李彦仕，E-mail：1272870675@qq.com
  左汶奇，E-mail：zuowenqi@163.com
- 基金信息：
  
  重庆医科大学研究生人工智能赋能课程建设项目”高级临床听力学“(AI2025003);国家耳鼻咽喉疾病临床医学研究中心开发课题项目“基于大数据的反向传播神经网络机器学习模型在预测突发性耳聋发病率中的价值探讨”(2024KF020)
- DOI：10.3969/j.issn.1672-4933.2026.05.014
  中图分类号： R764.45
- 收稿：2026-03-30，
  
  修回：2026-08-03，
  
  录用：2026-08-15，
  
  纸质出版：2026-09-15
- 稿件说明：
移动端阅览
张玉婷,郑昱晓,刘思远等.乙状窦源性耳鸣机制与诊疗研究进展[J].中国听力语言康复科学杂志,2026,24(05):524-529.

ZHANG Yu-ting,ZHENG Yu-xiao,LIU Si-yuan,et al.Advances in Mechanisms, Diagnosis and Treatment of Sigmoid Sinus Associated Pulsatile Tinnitus[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(05):524-529.
张玉婷,郑昱晓,刘思远等.乙状窦源性耳鸣机制与诊疗研究进展[J].中国听力语言康复科学杂志,2026,24(05):524-529. DOI： 10.3969/j.issn.1672-4933.2026.05.014.

ZHANG Yu-ting,ZHENG Yu-xiao,LIU Si-yuan,et al.Advances in Mechanisms, Diagnosis and Treatment of Sigmoid Sinus Associated Pulsatile Tinnitus[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(05):524-529. DOI： 10.3969/j.issn.1672-4933.2026.05.014.

摘要

乙状窦源性耳鸣是一种由乙状窦周围血管结构异常或血流动力学改变引发的搏动性耳鸣，其耳鸣节律通常与心跳一致。本文梳理了乙状窦源性耳鸣在临床特征、病因学、治疗方案及疗效、计算流体力学技术和机器学习等方面研究进展。目前，乙状窦源性耳鸣以女性发病为主，右侧发病常见，可伴低频听力损失，同时年轻化更明显。其病因机制呈现多因素协同特征，解剖结构异常、血流动力学改变、脑脊液和颅内压改变等共同参与乙状窦源性耳鸣的发生发展，具体病因之间的关系有待进一步研究。乙状窦源性耳鸣的治疗方案以乳突径路手术治疗为主，主要是乙状窦骨壁重建术及其相关术式，国内外研究在修补材料上存在差异，不同机构的手术方法不同，导致疗效不一，且不能直接比较手术方法的优劣。手术治疗的短期疗效较好，但长期疗效有待进一步研究。近年来，计算流体力学技术在其病理机制和诊疗技术研究方面提供了有力支持，机器学习则在自动识别异常区域和自动化辅助诊断方面有了新进展。今后，可进一步开展多中心、大样本、采用统一标准的前瞻性研究，为乙状窦源性耳鸣的治疗及机制研究提供高质量证据，为自动化诊断提供经验。

Abstract

Sigmoid sinus associated pulsatile tinnitus is a type of pulsatile tinnitus caused by structural abnormalities of the vasculature surrounding the sigmoid sinus or by hemodynamic alterations

with a rhythm typically synchronous with the heartbeat. This review summarizes the current literature on sigmoid sinus associated pulsatile tinnitus with respect to clinical characteristics

etiology

treatment strategies and outcomes

computational fluid dynamics techniques

and machine learning applications. Current evidence indicates a female predominance

a predilection for the right side

and an association with low-frequency hearing loss

with a notably younger age of onset. The underlying pathogenic mechanisms exhibit multifactorial synergistic features

in which anatomical anomalies

hemodynamic changes

and alterations in cerebrospinal fluid and intracranial pressure collectively contribute to the development of sigmoid sinus associated pulsatile tinnitus; however

the interrelationships among these specific etiological factors warrant further investigation. Surgical intervention via the mastoid approach remains the mainstay of treatment

predominantly sigmoid sinus wall reconstruction and its related variants. Differences in grafting materials exist between domestic and international studies

and variations in surgical techniques across different centers have led to heterogeneous outcomes

precluding direct comparisons of the relative efficacy of different surgical methods. Based on current data

short-term surgical outcomes are favorable

but long-term results require further validation. In recent years

computational fluid dynamics has provided robust support for investigating pathological mechanisms and refining diagnostic and therapeutic approaches

while machine learning has advanced the automated identification of abnormal regions and computer-aided diagnosis. Future clinical research should focus on multicenter

large-sample

prospective studies with standardized protocols to generate higher-quality evidence for both treatment and mechanistic exploration of sigmoid sinus associated pulsatile tinnitus

and to accumulate experience for automated diagnostic systems.

关键词

Keywords

references

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