The position and shape of the jugular bulb are undependable, and thus can add difficulty to temporal bone surgery. The present study addresses the hypothesis that position and shape of the jugular bulb correlate with the extent of temporal bone pneumatization. Systematic study was done in 25 unilateral cadaver specimens. Pneumatization was determined using both the classic Runström II radiograph, and computed tomography. Jugular bulb shape and position were determined by anatomic dissection and computed tomography. No association of jugular bulb shape or position, with pneumatization, was found. However, the dissection-determined distance from the plane of the lateral semicircular canal to the roof of the jugular bulb (2 to 15 mm), had a good correlation (r = 0.70, p less than .001) with the distance from the internal auditory canal to the apex of the jugular bulb (1.5 to 15.0 mm).

The familial occurrence of otitis media was studied in White Mountain Apache Indians at Canyon Day, Arizona. Of the 760 residents, 366 persons were seen during a village survey for otitis media. There were 133 first-degree relatives involving 113 first-degree relative pairs. Of these, there were 38 children involving 19 separate sibling pairs, for whom age- and sex-matched controls could be assigned. Tympanic membrane scarring was assumed to be a marker of prior otitis media. The findings suggested (P less than .01 for the nonindependent first-degree relative pairs, and P less than .05 for the independent sibling pairs) a familial predisposition. With the additional assumption that the severity of tympanic membrane scarring can be ranked, no association of severity of otitis media was apparent in the first-degree relatives.

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The anatomy of the anterior epitympanic space is complex and relatively unfamiliar to the surgeon. The size of the space is unpredictable. From the surgeon’s perspective, we studied the bony anatomy of the anterior epitympanic space in 35 cadavers. There was an impressive variability of bony openness into the anterior mesotympanum; the openness was bilaterally symmetrical. As a potential auxiliary ventilation route for the epitympanum of the chronic otitis patient, each specimen was found to have sufficient room to surgically establish a route at least 2 mm in diameter to connect with the anterior mesotympanum. None of the specimens had dehiscent facial nerve in the anterior epitympanic space, but 60% of specimens had dehiscent facial nerve adjacent to the stapes. The anatomic variations of the anterior epitympanic space were not related to prior otitis media. Three fourths of the medial walls of the anterior epitympanic spaces lacked the bony trabeculae that are otherwise typical of the epitympanum. Because the medial wall contours were bilaterally symmetrical, because the contours were unassociated with indicators of prior otitis media, and because of apparent contour differences in Orientals and Caucasians, a congenital factor is suggested to determine the contour of the medial wall of the anterior epitympanic space.