Therapeutic Efficacy of Angiocatheter Insertion Surgery in the Bony Orifice of Patulous Eustachian Tube / 대한이비인후과학회지

Patulous Eustachian tube is a benign, but bothersome condition, which can cause severe physical and psychological problems. We investigated the clinical features and the therapeutic result of the surgery in three patients, whose patulous Eustachian tube symptom were treated by the surgical insertion of a specially designed, tripod-tipped-bone wax-filled angiocatheter into the bony orifice of the Eustachian tube. Immediate disappearance of the troublesome symptoms was observed in all six patients. No serious complications were observed during the follow-up period. Factors considered for this surgical therapy and the method of designing our specific angiocatheter are introduced in detail. Surgical therapy for patients with serious patulous Eustachian tube symptoms by inserting the tripod-tipped-bone wax-filled angiocatheter seemed promising. Further studies on its long-term therapeutic effects might be necessary using a large number of the patients.

A Case of Vestibular Paroxysmia Offended by Vertebral Artery / 대한이비인후과학회지

Vestibular paroxysmia, which is caused by neurovascular cross-compression of the eighth cranial nerve, is characterized by recurrent vertiginous spells and other audiologic symptoms such as tinnitus, aural fullness and hearing impairment. Magnetic resonance image may show the eighth cranial nerve compression by vessels in the posterior fossa such as the anterior-inferior cerebellar, posterior-inferior cerebellar, basilar, or vertebral arteries. Medical therapy including carbamazepine, phenytoin or gabapentin and microvascular decompression of the eighth cranial nerve can be contemplated. Here, we report of a 51 year-old man who presented with recurrent vertigo attacks and tinnitus. His symptoms were aggravated by positional change. Videonystagmography and auditory brainstem response showed abnormal results. Magnetic resonance image showed the eighth cranial nerve compression caused by the vascular loop. The offending vessel was revealed as vertebral artery. He was treated with carbamazepine and showed no recurrent symptoms. We report this rare case with a review of the relevant literatures.