搏動性耳鳴需考慮腫瘤性或血管性的病灶。一42歲女性,每每於夜間睡眠平躺,頭向左側轉時就會引發右側搏動性耳鳴,鑒於病症已經10年,求診於本院。經過理學檢查、聽力檢查、動脈超音波及合併血管造影之磁振造影等一系列的檢查後,證實為右側椎動脈發育不全及基底動脈彎曲,尚無其他異常。本個案在服用β受體拮抗劑1週後,病症消失,但只要停止服藥,病症會復發。經過半年的追蹤,情況依然穩定,再追蹤其動脈超音波。我們認為,應是本個案向左轉頭時,引起椎基底動脈之血流動力學變化,造成右側搏動性耳鳴。由於臨床上搏動性耳鳴不算多見,但大多數原因不明,特報告此個案。
Pulsatile tinnitus (PT) might be attributable to a neoplasm or vascular lesion. A 42-year-old female has been bothered with right PT when lying in bed and a leftward rotating head every night for ten years. The physical examination, audiometry, color-coded duplex sonogram and magnetic resonance image/angiography revealed unremarkable, except the right vertebral artery hypoplasia and a twisted basilar artery. After she had regularly taken an β-antagonist for a week, the PT subsided. However, the PT would recur if she halted medication. Over the following half a year, it was uneventful and color-coded duplex sonogram was the follow-up. We suggest hemodynamic change of the vertebral-basilar artery secondary to leftward head rotation led to her right PT. PT is clinically uncommon, and most of them are of unknown etiology, so we report the case herein.