System and device for treating tinnitus caused by internal jugular vein stenosis by decompression of the transverse process of atlas

Abstract

The present invention belongs to the field of intelligent medical treatment, and specifically relates to a system and device for treating tinnitus caused by internal jugular vein stenosis by decompression of the atlas transverse process. The system comprises: a positioning and anatomical processing unit 101: used to make a line along the mastoid tip and the surface projection point of the atlas transverse process, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the atlas transverse process; a grinding processing unit 102: used to locate and expose the anterolateral bone of the atlas transverse process, define the anterolateral bone grinding range, and grind the defined anterolateral bone range; a perfusion processing unit 103: used to increase the systolic pressure on the basis of the patient's basal blood pressure, so that the compressed and narrowed internal jugular vein bulges and re-expands, and the re-expanded internal jugular vein refers to an increase in the blood flow and the acceleration of the blood flow rate of the internal jugular vein, so that the cross-section of the internal jugular vein is close to a regular circle, and the external appearance shows that the internal jugular vein is tubular and re-expanded.

Description

Technical Field

[0001] The present invention relates to the field of intelligent medical treatment, and more specifically, to a system and device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas. Background Art

[0002] Tinnitus, also known as cranial tinnitus, is a self-reported sound in the skull that patients feel. It can be manifested as complex sounds such as machine sounds, thunder and whistles, and can occur intermittently or continuously. The cause of tinnitus is still unclear. Literature reports that cerebral venous blood return disorders can easily lead to tinnitus, which is often accompanied by symptoms including tinnitus and hearing loss, dry eyes, headache and dizziness, neck and shoulder pain, cognitive and autonomic dysfunction, sleep disorders, anxiety and depression, memory loss, etc., which seriously affect patients' daily lives and bring great pain to patients.

[0003] Internal jugular vein stenosis (IJVS) is one of the important causes of cerebral venous reflux obstruction, and compression by external factors is one of the main causes of internal jugular vein stenosis or even occlusion, among which compression by the transverse process and styloid process of the atlas accounts for the highest proportion. However, there is no clear report on its clinical diagnostic criteria and surgical indications. Summary of the invention

[0004] In order to better solve the problem of tinnitus caused by obstruction of internal jugular vein reflux due to compression and stenosis of the upper segment of the internal jugular vein, the present invention provides a system for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas, and introduces release technology and perfusion technology, so that partial grinding of the transverse process of the atlas can achieve the purpose of better treating tinnitus.

[0005] The present application (first aspect) discloses a system for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas, comprising:

[0006] The positioning and dissection processing unit 101 is used to draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas;

[0007] The grinding processing unit 102 is used to locate and expose the anterolateral bone of the transverse process of the atlas, define the anterolateral bone grinding range, and grind the defined anterolateral bone range;

[0008] Perfusion processing unit 103: is used to increase the systolic blood pressure on the basis of the patient's basal blood pressure, so as to make the compressed and narrowed internal jugular vein swell and expand. The expanded internal jugular vein means that the blood flow rate and velocity of the internal jugular vein are increased, so that the cross section of the internal jugular vein is close to a regular circle, and the internal jugular vein can be seen to be tubular in appearance.

[0009] Furthermore, the system further includes a release processing unit 103-0 between the abrasion processing unit 102 and the perfusion processing unit 103: used to release muscles, arteries and other soft tissues around the internal jugular vein that may cause restraint, restore the physiological and anatomical morphology of the internal jugular vein, and achieve sufficient decompression.

[0010] Furthermore, the positioning and dissection processing unit 101 also includes a partial separation processing unit 101-2: used for separating part of the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas, wherein the partial separation processing is to locally separate the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas.

[0011] Furthermore, the perfusion treatment unit increases the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure through drugs for 30 minutes.

[0012] Furthermore, the grinding processing unit uses a bone power system to grind the anterolateral bone of the transverse process of the atlas, with a grinding range of 5-10mm.

[0013] Furthermore, the system further comprises a suturing unit 104 after the perfusion processing unit, for suturing the surgical incision.

[0014] Furthermore, the positioning anatomical processing unit is used to locate the surface projection of the mastoid tip and the transverse process of the atlas, and the surface projection of the transverse process of the atlas is used as the incision center. A surgical incision is formed along the line connecting the surface projection points of the mastoid tip and the transverse process of the atlas, and the skin and the platysma muscle are cut layer by layer from shallow to deep through the surgical incision, the anterior edge of the sternocleidomastoid muscle and the posterior belly of the digastric muscle are separated, the fat gap is cut to expose the transverse process of the atlas, and the muscles and soft tissues attached to the anterior and lateral sides of the transverse process of the atlas are partially separated to expose the anterior and lateral bones of the transverse process of the atlas.

[0015] The second aspect of the present application discloses a device for treating tinnitus caused by internal jugular vein stenosis by decompression of the transverse process of the atlas, the device comprising: a single or multiple processors, and a memory; the memory is used to store a single or multiple computer program instructions; when the single or multiple computer programs are executed by the single or multiple processors, the following steps are implemented:

[0016] S101: used to draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas;

[0017] S102: used to locate and expose the anterolateral bone of the transverse process of the atlas, define the range of anterolateral bone removal, and remove the defined anterolateral bone range;

[0018] S103-0: Used to release the muscles, arteries and other soft tissues around the internal jugular vein that may cause confinement, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression.

[0019] S103: It is used to increase the systolic blood pressure on the basis of the patient's basal blood pressure, so as to make the compressed and narrowed internal jugular vein swell and expand. The expanded internal jugular vein refers to an increase in the blood flow and the acceleration of the blood flow rate in the internal jugular vein, so that the cross-section of the internal jugular vein approaches a regular circle, and the internal jugular vein can be seen to be tubular in appearance.

[0020] Furthermore, when the single or multiple computer programs are executed by the single or multiple processors, the following steps are implemented:

[0021] S101-0: fix the affected side on top;

[0022] S101: Draw a line along the projection points of the mastoid tip and the atlas transverse process on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, expose the atlas transverse process, and locally separate the muscles and soft tissues attached to the anterolateral side of the atlas transverse process;

[0023] S102: locating and exposing the anterolateral bone of the transverse process of the atlas, defining the range of anterolateral bone removal, and removing the defined anterolateral bone range;

[0024] S103: Release the muscles, arteries and other soft tissues around the internal jugular vein that may cause confinement, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression;

[0025] S104: Use drugs to raise the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure for 30 minutes;

[0026] S105: Suture the surgical incision.

[0027] Furthermore, the device comprises: a positioning dissection component, a grinding component, and an injection component.

[0028] Furthermore, the positioning dissection parts include: tissue scissors, microscopic scissors, mucosal and periosteal strippers;

[0029] The grinding piece includes: a grinding drill;

[0030] The injection piece includes: a drug dispenser.

[0031] Furthermore, the device also includes one or more of the following: a loosening part, a suturing part, and an imaging part.

[0032] Furthermore, the release component includes: a releaser; the suturing component includes: a hemostatic material, a surgical suture; the imaging component includes: a Pentero microscope, a Storze endoscope; the abrasion component also includes: a bone power system.

[0033] This application has the following beneficial effects:

[0034] 1. This application proposes a system for decompressing the transverse process of the atlas to treat tinnitus caused by internal jugular vein stenosis. The system can perform surgery to remove the anterolateral part of the bone of the transverse process of the atlas, thereby decompressing the internal jugular vein and achieving the effect of treating tinnitus. The present invention also introduces a release technique. After removing the anterolateral part of the bone of the transverse process of the atlas, a release technique is used to release the muscles, arteries and other soft tissues around the internal jugular vein that may cause restraint, restore the physiological anatomical morphology of the internal jugular vein, achieve sufficient decompression, and obtain better surgical results.

[0035] 2. The present invention also introduces perfusion technology. After grinding away the anterolateral bone of the transverse process of the atlas, the perfusion technology is used to increase the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure through drugs for 30 minutes, so that the compressed and narrowed internal jugular vein can swell and expand, rebuild the blood return mechanism, and obtain better surgical results. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings required for use in the description of the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative work.

[0037] Figure 1 A first aspect of an embodiment of the present invention provides a schematic diagram of a system flow chart;

[0038] Figure 2 It is a schematic diagram of a surgical incision provided by an embodiment of the present invention, in which ① represents the earlobe, ② represents the mastoid process, and ③ represents the surface projection of the transverse process of the atlas.

[0039] Figure 3 This is a schematic diagram of a positioning anatomical processing unit cutting skin and subcutaneous tissue provided by an embodiment of the present invention, wherein ① represents an earlobe;

[0040] Figure 4 1 is a schematic diagram of the position of the sternocleidomastoid muscle provided by an embodiment of the present invention, wherein ① represents the earlobe; ② represents the surgical incision; ③ represents the sternocleidomastoid muscle;

[0041] Figure 5 1 is a schematic diagram of the positions of the transverse process of the atlas and the internal jugular vein provided by an embodiment of the present invention, wherein ① represents the transverse process of the atlas; ② represents the accessory nerve; ③ represents the internal jugular vein; ④ represents the internal carotid artery; and ⑤ represents the styloid process. DETAILED DESCRIPTION

[0042] In order to enable those skilled in the art to better understand the solutions of the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present invention.

[0043] In some of the processes described in the specification and claims of the present invention and the above-mentioned figures, multiple operations that appear in a specific order are included, but it should be clearly understood that these operations may not be executed in the order in which they appear in this article or executed in parallel. The sequence numbers of the operations, such as S101, S102, etc., are only used to distinguish between different operations, and the sequence numbers themselves do not represent any execution order. In addition, these processes may include more or fewer operations, and these operations may be executed in sequence or in parallel. It should be noted that the descriptions of "first", "second", etc. in this article are used to distinguish different messages, devices, modules, etc., do not represent the order of precedence, and do not limit the "first" and "second" to be different types.

[0044] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative work are within the scope of protection of the present invention.

[0045] Figure 1 The present invention provides a schematic diagram of a system flow based on evaluating atlas transverse process decompression for treating tinnitus caused by internal jugular vein stenosis. Specifically, the system includes:

[0046] The positioning and dissection processing unit 101 is used to draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas;

[0047] In some embodiments, the positioning anatomical processing unit is used to locate the surface projection of the mastoid tip and the transverse process of the atlas, and the surface projection of the transverse process of the atlas is used as the incision center. A surgical incision is formed along the line connecting the surface projection points of the mastoid tip and the transverse process of the atlas, and the skin and the platysma muscle are cut layer by layer from shallow to deep through the surgical incision, the anterior edge of the sternocleidomastoid muscle and the posterior belly of the digastric muscle are separated, the fat gap is cut to expose the transverse process of the atlas, and the muscles and soft tissues attached to the anterior and lateral sides of the transverse process of the atlas are partially separated to expose the anterior and lateral bones of the transverse process of the atlas.

[0048] In some embodiments, the partial separation processing unit is for separating part of the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas, and the partial separation processing is for locally separating the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas.

[0049] In some embodiments, the length of the surgical incision is 2 to 4 cm.

[0050] In a specific embodiment, the length of the surgical incision is 3 cm.

[0051] In some embodiments, the positioning anatomical processing unit includes a mastoid tip positioning module, which locates the mastoid tip on the affected side of the patient; wherein the mastoid tip positioning program is obtained based on artificial intelligence model training.

[0052] In some embodiments, the positioning anatomical processing unit includes a mastoid tip positioning module, which locates the mastoid tip on the affected side of the patient after acquiring the position of the mastoid tip.

[0053] In some embodiments, the positioning anatomical processing unit includes an atlas transverse process surface projection positioning module, which locates the atlas transverse process surface projection on the patient's affected side based on an atlas transverse process surface projection positioning model, wherein the atlas transverse process surface projection positioning model is obtained based on training of an artificial intelligence model.

[0054] In some embodiments, the positioning and anatomical processing unit includes a bone detection module, and when the set cutting depth reaches the transverse process of the atlas, the cutting is stopped according to the feedback of the bone detection module. The program of the bone detection module is obtained based on artificial intelligence model training.

[0055] In some embodiments, the positioning and anatomical processing unit slowly approaches the transverse process of the atlas according to the input incision depth.

[0056] In some embodiments, a partial separation processing unit 101-2 is also included between the positioning and dissection processing unit and the grinding processing unit: used to separate part of the muscles and soft tissues attached to the anterolateral side of the atlas transverse process, and the partial separation processing is to locally separate the muscles and soft tissues attached to the anterolateral side of the atlas transverse process.

[0057] The grinding processing unit 102 is used to locate and expose the anterolateral bone of the transverse process of the atlas, define the anterolateral bone grinding range, and grind the defined anterolateral bone range;

[0058] In some embodiments, the abrasion processing unit includes an anterolateral bone identification program for locating the anterolateral bone of the transverse process of the atlas; the anterolateral bone identification program is obtained based on artificial intelligence model training.

[0059] In some embodiments, the positioning information of the anterolateral bone of the transverse process of the atlas is obtained.

[0060] In some embodiments, the grinding processing unit includes an anterolateral bone grinding range delineation program; the anterolateral bone grinding range delineation program obtains the grinding range of the anterolateral bone of the transverse process of the atlas based on artificial intelligence model training.

[0061] In some embodiments, the grinding range of the anterolateral bone of the transverse process of the atlas is obtained; and the grinding processing unit defines the anterolateral bone grinding range according to the obtained grinding range.

[0062] In some embodiments, the abrasion treatment unit uses a bone power system to abrade the anterolateral bone range.

[0063] In some embodiments, the obtained grinding range is 5-10 mm;

[0064] In some embodiments, the anterolateral bone identification module accurately identifies the anterolateral bone of the transverse process of the atlas with the assistance of an endoscope and a microscope.

[0065] 103-0 Release treatment unit: used to release possible restraints around the internal jugular vein

[0066] The muscles, arteries and other soft tissues can be restored to restore the physiological and anatomical morphology of the internal jugular vein and achieve full decompression.

[0067] Release technique: During the decompression of the internal jugular vein by partially grinding the transverse process of the atlas, due to the close relationship between the internal jugular vein and the internal carotid artery, the neck muscles and bone structure, the soft tissue around the internal jugular vein may be squeezed by the anterolateral side of the transverse process of the atlas, which will bind the internal jugular vein, leading to cerebral venous return obstruction, cerebral blood stasis, and affect the chronic metabolism of brain cells, thus causing brain tinnitus. Therefore, after grinding the anterolateral bone of the transverse process, the tissue around the internal jugular vein is fully released to restore the physiological and anatomical morphology of the internal jugular vein and achieve full decompression. In summary, the full release of the surrounding tissue that binds the internal jugular vein is defined as the release technique. Clinical studies have further proved that the decompression of the internal jugular vein by partially grinding the transverse process of the atlas using the release technique is better than that of simple grinding.

[0068] Perfusion processing unit 103: is used to increase the systolic blood pressure on the basis of the patient's basal blood pressure, so as to make the compressed and narrowed internal jugular vein swell and expand. The expanded internal jugular vein means that the blood flow rate and velocity of the internal jugular vein are increased, so that the cross section of the internal jugular vein is close to a regular circle, and the internal jugular vein can be seen to be tubular in appearance.

[0069] Perfusion technique: During the decompression surgery of the internal jugular vein by partially removing the transverse process of the atlas, after fully removing the anterior and lateral bone of the transverse process, before suturing the incision, the patient's systolic blood pressure is raised to 20-30 mmHg above the baseline blood pressure through drugs for 30 minutes to promote the expansion and dilation of the internal jugular vein. This is the perfusion technique. Clinical studies have found that the decompression surgery of the internal jugular vein by partially removing the transverse process of the atlas using the perfusion technique is more effective than the simple removal surgery. The reason may be that the perfusion technique increases the blood flow to the brain and improves the blood return of the internal jugular vein, so that it reaches the ideal expansion and dilation state before suturing the incision, rebuilds the blood return mechanism, and ensures the effect of the surgery.

[0070] In some embodiments, the perfusion treatment unit increases the patient's systolic blood pressure level via medication.

[0071] In some embodiments, the perfusion treatment unit increases the patient's systolic blood pressure by 20-30 mmHg above the basal blood pressure for 30 minutes using medication.

[0072] In some embodiments, the perfusion processing unit determines whether the patient's internal jugular vein has reached a distended state through a venous status detection module; wherein the venous status detection module is trained based on an artificial intelligence model.

[0073] In some specific embodiments, the surgical robot is equipped with a system for decompressing the transverse process of the atlas to treat tinnitus caused by internal jugular vein stenosis. The surgical robot anesthetizes the patient based on the acquired patient information and fixes the patient with the affected side on top. The surface projections of the mastoid tip and the transverse process of the atlas are located based on machine vision recognition. The surface projection of the transverse process of the atlas is used as the center of the incision, and a surgical incision is formed along the line connecting the surface projection points of the mastoid tip and the transverse process of the atlas. The skin and the platysma muscle are cut layer by layer from shallow to deep through the surgical incision, the anterior edge of the sternocleidomastoid muscle and the posterior belly of the digastric muscle are separated, the fat gap is cut to expose the transverse process of the atlas, the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas are partially separated, and the anterior and lateral bone of the transverse process of the atlas are exposed. The surgical robot locates the anterolateral bone of the transverse process of the atlas based on machine vision, demarcates the range of anterolateral bone removal that needs to be removed according to the prediction model, and then uses the bone power system to quickly and accurately remove the demarcated anterolateral bone range; after removing the anterolateral part of the transverse process bone, the muscles, arteries and other soft tissues around the internal jugular vein that may cause a restraining effect are released, the physiological anatomical morphology of the internal jugular vein is restored, and full decompression is achieved. After the release treatment, the surgical robot increases the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure by injecting drugs for 30 minutes to promote the bulging and expansion of the internal jugular vein. After the bulging and expansion of the internal jugular vein, the surgical incision is sutured after judging that there is no active bleeding based on computer vision detection.

[0074] In some embodiments, a system for treating tinnitus caused by internal jugular vein stenosis using atlas transverse process decompression comprises:

[0075] The positioning and dissection processing unit 101 is used to draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas;

[0076] The grinding processing unit 102 is used to locate and expose the anterolateral bone of the transverse process of the atlas, define the anterolateral bone grinding range, and grind the defined anterolateral bone range;

[0077] Release treatment unit 103-0: used to release the muscles, arteries and other soft tissues around the internal jugular vein that may cause restraint, restore the physiological and anatomical morphology of the internal jugular vein, and achieve full decompression;

[0078] Perfusion processing unit 103: is used to increase the systolic blood pressure on the basis of the patient's basal blood pressure, so as to make the compressed and narrowed internal jugular vein swell and expand. The expanded internal jugular vein means that the blood flow rate and velocity of the internal jugular vein are increased, so that the cross section of the internal jugular vein is close to a regular circle, and the internal jugular vein can be seen to be tubular in appearance.

[0079] In some embodiments, when the single or multiple computer programs are executed by the single or multiple processors, the following steps are performed:

[0080] S101-0: fix the affected side on top;

[0081] S101: Draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas;

[0082] S101-2: Separate part of the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas, wherein the partial separation process is to locally separate the muscles and soft tissues attached to the anterolateral side of the transverse process of the atlas.

[0083] S102: locating and exposing the anterolateral bone of the transverse process of the atlas, defining the range of anterolateral bone removal, and removing the defined anterolateral bone range;

[0084] S103-0: Release the muscles, arteries and other soft tissues around the internal jugular vein that may cause confinement, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression;

[0085] S103: Inject drugs to raise the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure for 30 minutes to promote the expansion of the internal jugular vein.

[0086] S104: Suture the surgical incision.

[0087] In some embodiments, patients with stenosis of the upper segment of the internal jugular vein due to bony compression and accompanied by different degrees of tinnitus were collected and followed up for 6-30 months. Preoperatively, jugular vein CT and jugular vein ultrasound were mainly used to evaluate the compression of the internal jugular vein, which confirmed that the internal jugular vein stenosis was caused by compression of the atlas transverse process. 27 patients underwent unilateral atlas transverse process partial grinding and decompression, and 5 underwent bilateral atlas transverse process partial grinding and decompression. Results: Among the 32 patients, the total improvement rate of postoperative tinnitus and accompanying symptoms was 62.5% (20 / 32), the improvement rate of internal jugular vein stenosis was 84.3% (27 / 32), and the blood flow improvement rate was 75.0% (24 / 32). The degree of improvement of internal jugular vein blood flow was significantly improved in patients with progressive tinnitus (early + middle stage tinnitus) compared with patients with persistent tinnitus (P=0.016). Complications included 1 case of intraoperative internal jugular vein injury, 1 case of weak shrug and neck rotation, 1 case of neck and shoulder discomfort, and 1 case of incision infection. Conclusion: Partial removal of the atlas transverse process for internal jugular vein decompression can effectively relieve the compression and stenosis of the upper segment of the internal jugular vein, improve the morphology and blood flow of the internal jugular vein, and relieve the clinical symptoms of patients.

[0088] In some embodiments, patients with stenosis of the upper segment of the internal jugular vein due to bony compression and accompanied by varying degrees of tinnitus symptoms were collected from January 2020 to September 2022 and followed up for 6-30 months. Preoperatively, jugular vein CT and jugular vein ultrasound were mainly used to evaluate the compression of the internal jugular vein, confirming that the internal jugular vein stenosis was caused by compression of the transverse process of the atlas. 15 patients underwent partial grinding and decompression of the transverse process of the atlas alone, and 32 patients underwent partial grinding and decompression of the transverse process of the atlas combined with release and perfusion techniques. The follow-up analysis of these patients was statistically analyzed using SPSS 25.0 statistical software. Normally distributed quantitative variables were expressed as mean ± standard deviation, and the comparison between groups was compared using t-test. Categorical variables were expressed as case numbers and percentages, and the chi-square test was used for comparison between groups. All tests were bilateral, and P < 0.05 was considered statistically significant. The results showed that the prognosis of 32 patients who underwent partial atlas transverse process decompression combined with release and perfusion technology was significantly better than that of 15 patients who underwent partial atlas transverse process decompression alone.

[0089] (1) Improvement of the internal jugular vein morphology before and after surgery:

[0090] Among the 15 patients who underwent partial atlas transverse process removal surgery, CTV examination showed that the degree of internal jugular vein stenosis was significantly improved in 2 patients (2 / 15; 13.33%), slightly improved in 5 patients (3 / 15; 33.33%), and no significant change in 8 patients (10 / 15; 53.33%) 1 week after surgery. CTV examination showed that the degree of internal jugular vein stenosis was significantly improved in 17 patients (3 / 15; 53.1%), slightly improved in 10 patients (4 / 15; 31.3%), and no significant change in 5 patients (8 / 15; 15.6%) 3 months after surgery. The improvement rate of internal jugular vein stenosis in patients 3 months after surgery was 46.67% (7 / 15, 46.67%).

[0091] Among the 32 patients in the atlas transverse process partial grinding combined with release and perfusion technique group, CTV examination showed that the degree of internal jugular vein stenosis was significantly improved in 6 patients (6 / 32; 18.8%), slightly improved in 17 patients (17 / 32; 53.1%), no significant change in 8 patients (8 / 32; 25.0%), and aggravated in 1 patient (1 / 32; 3.1%) 1 week after surgery. CTV examination showed that the degree of internal jugular vein stenosis was significantly improved in 17 patients (17 / 32; 53.1%), slightly improved in 10 patients (10 / 32; 31.3%), and no significant change in 5 patients (5 / 32; 15.6%) 3 months after surgery. The improvement rate of internal jugular vein stenosis in patients 3 months after surgery was 84.3% (27 / 32). There was a significant statistical difference in the improvement rate of internal jugular vein stenosis between the two groups 3 months after surgery (p=0.019) (Table 1).

[0092] (2) Improvement of internal jugular vein blood flow before and after surgery:

[0093] Among the 15 patients who underwent partial atlas transverse process removal surgery, jugular vein ultrasound examination showed that the blood flow of the internal jugular vein was significantly improved in 1 patient (1 / 15; 6.67%), slightly improved in 2 patients (2 / 15; 13.33%), and no significant change in 12 patients (12 / 15; 80.0%) 1 week after surgery. Three months after surgery, jugular vein ultrasound examination showed that the blood flow of internal jugular vein stenosis was significantly improved in 2 patients (2 / 15; 13.33%), slightly improved in 4 patients (4 / 15; 26.67%), and no significant change in 9 patients (9 / 15; 60.0%). The improvement rate of internal jugular vein blood flow was 40.0% (6 / 15) 3 months after surgery.

[0094] Among the 32 patients in the atlas transverse process partial grinding combined with release and perfusion technique group, jugular vein ultrasound examination 1 week after surgery showed that the internal jugular vein blood flow was significantly improved in 1 patient (1 / 32; 3.1%), slightly improved in 7 patients (7 / 32; 21.9%), no significant change in 18 patients (18 / 32; 56.3%), and slowed down in 6 patients (6 / 32; 18.8%). Three months after surgery, jugular vein ultrasound examination showed that the blood flow of internal jugular vein stenosis was significantly improved in 6 patients (6 / 32; 18.75%), slightly improved in 18 patients (18 / 32; 56.25%), and no significant change in 8 patients (8 / 32; 25.0%). The improvement rate of internal jugular vein blood flow in patients three months after surgery was 75.0% (24 / 32). There was a significant statistical difference in the improvement of internal jugular vein blood flow between the two groups 3 months after surgery (p=0.02) (Table 1).

[0095] (3) Improvement of tinnitus and associated symptoms

[0096] Among the 15 patients who underwent partial atlas transverse process removal surgery, 0 patients (0 / 15; 0%) had significant improvement in tinnitus 1 week after surgery, 1 patient (1 / 15; 6.67%) had mild improvement in tinnitus, 2 patients (2 / 15; 13.33%) had no significant change in tinnitus but improved symptoms, 11 patients (10 / 15; 73.33%) had no change in symptoms, and 1 patient (1 / 15; 6.67%) had worsening tinnitus. 0 patients (0 / 15; 0%) had significant improvement in tinnitus 3 months after surgery, 1 patient (1 / 15; 6.67%) had mild improvement in tinnitus, 2 patients (2 / 15; 13.33%) had no significant change in tinnitus but improved symptoms, and 12 patients (12 / 15; 80.0%) had no change in symptoms. The total improvement rate of tinnitus symptoms was 6.67% (1 / 15), and the total improvement rate of clinical symptoms was 20% (3 / 15).

[0097] Among the 32 patients in the atlas transverse process partial grinding combined with release and perfusion technique group, 1 case (1 / 32; 3.1%) had significant improvement in tinnitus 1 week after surgery, 5 cases (5 / 32; 15.6%) had mild improvement in tinnitus, 11 cases (11 / 32; 34.4%) had no significant change in tinnitus but with improvement in symptoms, 13 cases (13 / 32; 40.6%) had no change in symptoms, and 2 cases (2 / 32; 6.3%) had aggravated tinnitus. Three months after surgery, 3 cases (3 / 32; 9.4%) had significant improvement in tinnitus, 6 cases (6 / 32; 18.6%) had mild improvement in tinnitus, 11 cases (11 / 32; 34.4%) had no significant change in tinnitus but with improvement in symptoms, and 12 cases (12 / 32; 37.5%) had no change in symptoms. The total improvement rate of tinnitus symptoms was 28.1% (9 / 32), and the total improvement rate of clinical symptoms of patients was 62.5% (20 / 32). There was no statistical difference in the total improvement rate of tinnitus symptoms between the two groups of patients 3 months after surgery (p=0.167), and there was also a significant statistical difference in the total improvement rate of clinical symptoms (p=0.007) (Table 1).

[0098] (4) Complications:

[0099] Among the 15 patients who underwent partial atlas transverse process removal surgery, 4 patients developed complications, including weak shrug and neck rotation in 1 case, neck and shoulder discomfort in 1 case, and wound infection in 1 case. The complication rate was 20% (3 / 15).

[0100] Among the 32 patients in the atlas transverse process partial grinding combined with release and perfusion technique group, 4 patients had complications: including intraoperative internal jugular vein injury: 1 case, shrug and weak neck rotation: 1 case, neck and shoulder discomfort: 1 case, and incision infection: 1 case. The complication rate was 12.5% ​​(4 / 32). There was no statistical difference in the complication rate between the two groups (p=0.815). The internal jugular vein ruptured and bled during the operation, and microvascular anastomosis was performed in the first stage during the operation. The incision infection healed after regular dressing changes. Patients with shrug, weak neck rotation, and neck and shoulder discomfort were given ganglioside treatment and hormone treatment after surgery, and acupuncture, physical therapy, and rehabilitation training were given after surgery, without affecting the quality of life.

[0101] (5) Hospitalization and follow-up:

[0102] The patients were discharged 3-5 days after surgery, with an average hospital stay of 4.6 days and a follow-up period of 6-24 months (average 17.6±3.8 months). No deaths occurred during the follow-up period.

[0103] Table 1 Differences in postoperative recovery between simple lateral atlas resection and lateral atlas resection combined with release and perfusion

[0104]

[0105] In summary, among the 15 patients who underwent partial decompression of the atlas transverse process alone, the total improvement rate of postoperative tinnitus and associated symptoms was 20% (3 / 15), the improvement rate of the degree of internal jugular vein stenosis was 46.67% (7 / 15), and the improvement rate of blood flow was 40.0% (6 / 15). Among the 32 patients who underwent decompression of the atlas transverse process combined with release and perfusion, the total improvement rate of postoperative tinnitus and associated symptoms was 62.5% (20 / 32), the improvement rate of the degree of internal jugular vein stenosis was 84.3% (27 / 32), and the improvement rate of blood flow was 75.0% (24 / 32). There were statistical differences between the two groups in the above three aspects (p values ​​were 0.019, 0.02, and 0.007, respectively), and there was no statistical difference in surgical complications between the two groups (p=0.815).

[0106] Conclusion: Partial removal of the atlas transverse process combined with release and perfusion techniques for internal jugular vein decompression can effectively relieve the compression and stenosis of the upper segment of the internal jugular vein, and is superior to simple partial removal of the atlas transverse process in improving the morphology and blood flow of the internal jugular vein and relieving the clinical symptoms of patients.

[0107] It should be noted that the flowcharts and block diagrams in the accompanying drawings illustrate the possible architecture, functions and operations of the systems, methods and computer program products according to various embodiments of the present disclosure. In this regard, each box in the flowchart or block diagram can represent a module, a program segment, or a part of a code, and the module, program segment, or a part of the code contains one or more executable instructions for implementing the specified logical function. It should also be noted that in some alternative implementations, the functions marked in the box can also occur in a different order from the order marked in the accompanying drawings. For example, two boxes represented in succession can actually be executed substantially in parallel, and they can sometimes be executed in the opposite order, depending on the functions involved. It should also be noted that each box in the block diagram and / or flowchart, and the combination of boxes in the block diagram and / or flowchart can be implemented with a dedicated hardware-based system that performs a specified function or operation, or can be implemented with a combination of dedicated hardware and computer instructions.

[0108] In general, various example embodiments of the present disclosure may be implemented in hardware or dedicated circuits, software, firmware, logic, or any combination thereof. Certain aspects may be implemented in hardware, while other aspects may be implemented in firmware or software that may be executed by a controller, microprocessor, or other computing device. When various aspects of the disclosed embodiments are illustrated or described as block diagrams, flow charts, or using some other graphical representation, it will be understood that the blocks, devices, systems, techniques, or methods described herein may be implemented in hardware, software, firmware, dedicated circuits or logic, general purpose hardware or controllers or other computing devices, or some combination thereof as non-limiting examples.

[0109] Those skilled in the art can clearly understand that, for the convenience and brevity of description, the specific working processes of the systems, devices and units described above can refer to the corresponding processes in the aforementioned method embodiments and will not be repeated here.

[0110] In the several embodiments provided in the present application, it should be understood that the disclosed systems, devices and methods can be implemented in other ways. For example, the device embodiments described above are only schematic. For example, the division of the units is only a logical function division. There may be other division methods in actual implementation, such as multiple units or components can be combined or integrated into another system, or some features can be ignored or not executed. Another point is that the mutual coupling or direct coupling or communication connection shown or discussed can be an indirect coupling or communication connection through some interfaces, devices or units, which can be electrical, mechanical or other forms.

[0111] The units described as separate components may or may not be physically separated, and the components shown as units may or may not be physical units, that is, they may be located in one place or distributed on multiple network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the solution of this embodiment.

[0112] In addition, each functional unit in each embodiment of the present invention may be integrated into one processing unit, or each unit may exist physically separately, or two or more units may be integrated into one unit. The above-mentioned integrated unit may be implemented in the form of hardware or in the form of software functional units.

[0113] The exemplary embodiments of the present disclosure described in detail above are merely illustrative and not restrictive. It should be understood by those skilled in the art that various modifications and combinations may be made to these embodiments or their features without departing from the principles and spirit of the present disclosure, and such modifications should fall within the scope of the present disclosure.

Claims

1. A system for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas, characterized in that: The system comprises: A positioning and dissection processing unit (101) is used to draw a line along the mastoid tip and the surface projection point of the atlas transverse process, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the atlas transverse process; A grinding processing unit (102): used to locate and expose the anterolateral bone of the transverse process of the atlas, define the anterolateral bone grinding range, and grind the defined anterolateral bone grinding range; Release treatment unit (103-0): used to release the muscles, arteries and other soft tissues around the internal jugular vein that may cause restraint to the internal jugular vein, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression; The perfusion processing unit (103) is used to increase the systolic blood pressure on the basis of the patient's basal blood pressure, so as to cause the compressed and narrowed internal jugular vein to expand and re-expand. The re-expanded internal jugular vein means that the blood flow rate and velocity of the internal jugular vein are increased, so that the cross-section of the internal jugular vein approaches a regular circle, and the internal jugular vein is visibly re-expanded in a tubular shape.

2. The system for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 1, characterized in that: The positioning and dissection processing unit (101) further comprises a partial separation processing unit (101-2): used for separating part of the muscles and soft tissues attached to the anterolateral side of the atlas transverse process, wherein the partial separation processing is to locally separate the muscles and soft tissues attached to the anterolateral side of the atlas transverse process.

3. The system for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 1, characterized in that: The perfusion treatment unit (103) uses drugs to increase the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure for 30 minutes.

4. The system for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 1, characterized in that: The grinding processing unit adopts a bone power system to grind the bone of the anterior and lateral sides of the transverse process of the atlas, and the grinding range is 5-10mm.

5. The system for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 1, characterized in that: The system further comprises a suturing unit (104) after the perfusion treatment unit, for suturing the surgical incision.

6. The system for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 1, characterized in that: The positioning anatomical processing unit is used to locate the surface projection of the mastoid tip and the transverse process of the atlas. The surface projection of the transverse process of the atlas is used as the incision center, and a surgical incision is formed along the line connecting the surface projection points of the mastoid tip and the transverse process of the atlas. The skin and the platysma muscle are cut layer by layer from shallow to deep through the surgical incision, the anterior edge of the sternocleidomastoid muscle and the posterior belly of the digastric muscle are separated, the fat gap is cut to expose the transverse process of the atlas, and the muscles and soft tissues attached to the anterior and lateral sides of the transverse process of the atlas are partially separated to expose the anterior part and lateral bone of the transverse process of the atlas.

7. A device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas, characterized in that: The device comprises: a single or multiple processors, and a memory; the memory is used to store a single or multiple computer program instructions; when the single or multiple computer programs are executed by the single or multiple processors, the following steps are implemented: S101: Draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas; S102: locating and exposing the anterolateral bone of the transverse process of the atlas, defining the range of anterolateral bone removal, and removing the defined anterolateral bone range; S103: Release the muscles, arteries and other soft tissues around the internal jugular vein that may bind the internal jugular vein, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression; use drugs to increase the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure for 30 minutes.

8. The device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas according to claim 7, characterized in that: When the single or multiple computer programs are executed by the single or multiple processors, the following steps are performed: S101-0: fix the affected side on top; S101: Draw a line along the projection points of the mastoid tip and the transverse process of the atlas on the body surface, form a surgical incision along the line, separate the muscle layer layer by layer along the surgical incision, and expose the transverse process of the atlas; S102: locating and exposing the anterolateral bone of the transverse process of the atlas, defining the range of anterolateral bone removal, and removing the defined anterolateral bone range; S103-0: Release the muscles, arteries and other soft tissues around the internal jugular vein that may cause a restraining effect, restore the physiological and anatomical morphology of the internal jugular vein, and achieve adequate decompression; S103: Use drugs to raise the patient's systolic blood pressure to 20-30 mmHg above the baseline blood pressure for 30 minutes; S104: Suture the cut muscles and skin.

9. The device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of the atlas according to claim 7, characterized in that: The device comprises: a positioning and dissecting part, a grinding part and an injection part.

10. The device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of atlas according to claim 9, characterized in that: The positioning dissection parts include: tissue scissors, microscopic scissors, mucosal and periosteal strippers; the grinding parts include: grinding drills; and the irrigation parts include: a drug delivery device.

11. The device for treating tinnitus caused by internal jugular vein stenosis by decompressing the transverse process of atlas according to claim 9, characterized in that: The device also includes one or more of the following: a releasing part, a suturing part, and an imaging part.

12. The device for treating tinnitus caused by internal jugular vein stenosis by decompressing the atlas transverse process according to claim 11, characterized in that: The release part includes: a release device; the suturing part includes: a hemostatic material and a surgical suture; the imaging part includes: a Pentero microscope and a Storze endoscope; the abrasion part also includes: Bone power system.

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