Effects of a High Jugular Fossa and Jugular Bulb Diverticulum on the Inner Ear

Abstract

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Menière's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiographed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

Temporal Bone Posterior Wall Defect, a New Clinic Entity?

“…The incidence of high jugular bulbs varies among authors and studies because of the variation in its definition. It was found to be approximately 3% when the inferior annulus had been selected as the reference structure [17] . Again, we have found an increased incidence of high jugular bulbs (8%) in patients with TBPWD, which supports the general knowledge implying that temporal bone anomalies commonly accompany each other.…”

Posterior Semicircular Canal and Vestibular Aqueduct Dehiscences Caused by Jugular Bulb Abnormalities

“…I found 18 (19.8 %) cases of the HJB. In the present report HJB was considered to be as above the level of the basal turn of the cochlea, superior tympanic annulus and/or reaching the level of the internal auditory canal (IAC) [4,6,8]. Among them four cases (22.2 %) of non-iatrogenic and non-traumatic vestibular aqueduct dehiscence (VAD) were determined (Fig.…”

“…However, an amount of the posterior semicircular canal dehiscence (PSCD) case reports remains small [4][5][6][7]. To date, as far as I know, fewer than 120 ears with PSCD can be found in the English-language literature.…”

Encountering a high jugular bulb during ear surgery

“…These abnormalities are often asymptomatic, though can cause pulsatile tinnitus, conductive hearing loss and vertigo, depending on position. 2 An awareness of this and an understanding the anatomical location of the bulb is essential.…”