PurposePulsatile tinnitus can be caused by a high-riding jugular bulb (HRJB), characterized by the superior position of the jugular bulb in the petrous temporal bone. The anatomical position and morphology of this entity make it challenging for endovascular treatment. We report our experience with two patients successfully treated with a stent-assisted Woven EndoBridge (WEB; Microvention, Tustin, CA, USA) device.Materials and MethodsWe describe two cases of HRJB in patients presenting with disabling pulsatile tinnitus. Temporary balloon occlusion of the jugular bulb prior to the intervention reduced tinnitus intensity. Both patients were subsequently treated under general anesthesia with the WEB device deployed in the HRJB which was held by a stent deployed in the sigmoid sinus.ResultsBoth procedures were successful with good positioning of the WEB device and no procedural complications. Both patients had complete resolution of pulsatile tinnitus immediately after the procedure. Follow-up imaging showed successful occlusion of the venous cavity with a widely patent stent.ConclusionAmong patients with pulsatile tinnitus caused by an ipsilateral HRJB, a stent-assisted WEB device seems to be a viable endovascular option with angiographic and clinical success.

中文翻译：

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支架辅助编织 EndoBridge 栓塞治疗同侧高位颈静脉球引起的搏动性耳鸣

目的搏动性耳鸣可由颈静脉球高位 (HRJB) 引起，其特征是颈静脉球位于岩颞骨的上方。该实体的解剖位置和形态使得血管内治疗具有挑战性。我们报告了两名患者使用支架辅助编织 EndoBridge（WEB；Microvention，塔斯廷，加利福尼亚州，美国）装置成功治疗的经验。材料和方法我们描述了两例出现致残性搏动性耳鸣的 HRJB 患者。干预前对颈静脉球进行临时球囊闭塞可降低耳鸣强度。随后，两名患者均在全身麻醉下进行治疗，将 WEB 装置部署在 HRJB 中，并由部署在乙状窦中的支架固定。结果 两次手术均成功，WEB 装置定位良好，无手术并发症。手术后，两名患者的搏动性耳鸣立即完全消失。随访影像显示，广泛专利的支架成功闭塞了静脉腔。 结论 对于同侧 HRJB 引起的搏动性耳鸣患者，支架辅助 WEB 装置似乎是一种可行的血管内选择，血管造影和临床均取得成功。