椎基底動脈延長彎曲導致之單側持續性耳鳴

Dolicho-Tortuosity of the Vertebro-Basilar Artery Lead to Unilateral Persistent Tinnitus

陳建志(Jiann-Jy Chen) ； 陳登郎(Dem-Lion Chen) ； 楊菁華(Chin-Hua Yang)

《北市醫學雜誌》 6卷4期 (2009/08) Pp. 326-331

https://doi.org/10.6200/TCMJ.2009.6.4.08

摘要

大部分的耳鳴產生機制不明，可能涉及耳蝸、聽神經、聽覺神經路徑或聽覺中樞。－61歲男性，有高血壓性心臟病8年，長期服用aspirin，因左側持續性耳鳴1年求診於本科。耳鼻喉頭頸理學檢查並無異常發現，純音聽檢顯示兩側聽閾正常，但左側聽閾略高於右側，複響測試與語音辨識度檢查均為正常，其他心電圖、腦波圖、血液學檢查均為正常。腦部血管磁振造影顯示椎基底動脈延長彎曲、右側椎動脈發育不全及後顱窩循環分支變異。本個案疑因右側椎動脈發育不全，造成椎基底動脈延長彎曲，可能會與後顱窩循環分支變異及aspirin副作用一起影響到位於左側橋腦內之左側聽覺神經路徑。經服用ginkgo flavone glycoside 3個月後，耳鳴已經消失。

關鍵字

耳鳴 ； 椎基底動脈 ； 延長彎曲 ； 椎動脈發育不全 ； 後顱窩循環

並列摘要

Most tinnitus is of unknown etiology. The cochlea, the auditory nerve, the auditory pathway or the auditory center may be affected. A 61-year-old male had suffered from hypertensive heart disease and had taken aspirin for 8 days. He presented with a left persistent tinnitus for one year. An otorhinolaryngological examinations was normal. Pure tone audiometry showed normal hearing thresholds bilaterally, but the left hearing threshold was slightly higher than the right. The short increment sensitivity index and speech discrimination score were normal. An electrocardiogram, electroencephalogram, and blood examination results were normal. A magnetic resonance angiogram of the brain revealed dolichotortuosity of the vertebro-basilar artery (DTVBA), right vertebral artery hypoplasia and deficient branches of the posterior circulation (PC). In this case, it is possible that theright vertebral artery hypoplasia and PC deficient branches might have led to DTVBA, and then influenced the left auditory pathway in his pons together with the PC deficient branches and the side-effects of aspirin use. After he had taken ginkgo flavone glycoside for three months, his tinnitus subsided.

並列關鍵字

tinnitus ； vertebro-basilar artery ； dolicho-tortuosity ； vertebral artery hypoplasia ； posterior circulation