Latent High Jugular Bulb: Case Report and Significance of Neck Compression Test

Abstract

High jugular bulb is a vascular anomaly seen in the middle ear. In typical cases, the jugular bulb is easily observed through the tympanic membrane. We report here 3 patients with nontypical high jugular bulb. Their tympanic membranes were almost normal but protruded externally with pulsation when their necks were compressed. Computed tomography (CT) revealed jugular bulb protrusion into the tympanic cavities. We propose that this condition be named ‘latent high jugular bulb’. Neck compression easily detects this condition and may also be useful in the detection of other disorders of the middle ear that are related to the venous system.

Influence of phylogeny on jugular fossa shape and otological disorders

“…These hypotheses have been investigated from many aspects, e.g. age, sex, pneumatization, systemic disorder, human race (Solter and Paljan, 1973;West et al, 1974;Graham, 1977;Glasscock et al, 1980;Orr and Todd, 1988;Low et al, 1995;van Die et al, 1995).…”

“…The jugular fossa is subject to various clinical problems due to its size and position (Robin, 1972;Glasscock et al, 1980;Jahrsdoerfer et al, 1981;Buckwalter et al, 1983;Rouillard et al, 1985;Adler and Ropper, 1986;Hofmann and Nuesslein, 1989;Tsunoda et al, 1995). It sometimes protrudes directly into the tympanic cavity without a bony septum and causes bleeding during myringotomy or middle ear surgery.…”