Cholesteatoma Surgery With a Dehiscent High Jugular Bulb Treated With Surgery Assisted With Underwater Endoscopy: A Case Report

Abstract

A dehiscent high jugular bulb would be a pitfall in middle ear surgery especially for cholesteatoma. We report a case of cholesteatoma attached to a dehiscent high jugular bulb successfully treated with surgery assisted with underwater endoscopy. To the best of our knowledge, no previous study has reported a case of cholesteatoma with dehiscent high jugular bulb treated with surgery assisted with underwater endoscopy. Owing to the risk of jugular bulb injury, underwater endoscopy is a good indication for middle ear cases with a dehiscent high jugular bulb to obtain a clear operative field and avoid an unexpected air embolism.

Combined underwater endoscopic and microscopic surgery for tympanic paraganglioma: A case report

“… 12 , 13 This technique provides a clear operative field without the need for suction and also protects the inner ear and other important structures, including the JB, from unexpected aeration. 14 In cases of middle ear paragangliomas, significant bleeding can be experienced during surgery because of their vascular nature; thus, underwater endoscopy is appropriate for this case because of continuous blood and bone dust irrigation during suspicious bone drilling in the hypotympanum and around the ICA.…”

Combined underwater endoscopic and microscopic surgery for external auditory canal cholesteatoma: A case report

“…We have already reported the advantage of underwater ear surgery on cholesteatoma with a dehiscent high jugular bulb. 8 These underwater procedures kept a clear view by flushing out blood and dust (bone or tissue) from the operative site. Dähn et al reported the value of transcanal endoscopic surgery for external ear canal cholesteatoma up to Naim stage III.1 Our case was stage III external cholesteatoma placed on the middle posterior wall.…”