The Topographic Relations of the High Jugular Fossa to the Inner Ear

Wadin, K.; Wilbrand, Hermann

doi:10.1177/028418518602700312

Cited by 50 publications

(32 citation statements)

References 17 publications

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“…The HJB may be either medial or lateral to the cochlea. Therefore, a HJB is further subgrouped and defined as lateral HJB when the dome of the JB projects above the inferior aspect of the bony annulus [Overton and Ritter, 1973] or extends over the level of the round window and the basal turn of the cochlea [Atilla et al, 1995;Wadin and Wilbrand, 1986], and as a medial HJB when the dome is medial to the cochlea and reaches the level of the internal auditory canal [Atilla et al, 1995;Shao et al, 1993].…”

Section: Evaluation and Measuresmentioning

confidence: 99%

High Computed Tomographic Correlations between Carotid Canal Dehiscence and High Jugular Bulb in the Middle Ear

et al. 2010

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Both carotid canal dehiscence (CCD) and high jugular bulb (HJB) are thought to increase the potential for disastrous consequences during middle ear surgery. Clinical co-presentation of these two great vessel variants has not yet been described. This study aims to determine the relationship between CCD and HJB based on a computed tomographic (CT) temporal bone evaluation. High-resolution CT scans of 408 temporal bones obtained from 208 adults were recruited. Carotid canal integrity, jugular bulb position, petrous apex pneumatization and the minimal thickness of the carotid canal wall (TCW) facing the tympanic cavity were examined and measured for the incidence of CCD and/or HJB. Other variables including gender, age, laterality and the presence of otitis media or mastoiditis were also collected for analysis. CCD was found in 28 ears (6.9%); 19 of these were found to also have HJB (67.9%). The presence of CCD was significantly correlated with HJB presentation. The minimal TCW in HJB ears was significantly thinner than that of normally positioned jugular bulbs. Moreover, after controlling for other candidate variables, the independent factors of age (younger or older than 50 years) and jugular bulb position (high vs. normal) were found to predict the presence of CCD. In conclusion, HJB tends to coexist with a thinner carotid canal wall. This finding emphasizes the need to be watchful for the coexistence of these two great vessel anomalies when surgeons encounter an aged patient presenting either CCD or HJB during middle ear surgery.

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Section: Evaluation and Measuresmentioning

confidence: 99%

High Computed Tomographic Correlations between Carotid Canal Dehiscence and High Jugular Bulb in the Middle Ear

et al. 2010

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“…Bony PSCD due to a high jugular bulb has been reported by a number of authors 2–6 and can present with clinical findings similar to those seen with superior canal dehiscence. In a recent case series, the majority of patients with dehiscence of the posterior semicircular canal (11/12) was due to a high riding jugular bulb 4 .…”

Section: Introductionmentioning

confidence: 71%

Repair of Posterior Semicircular Canal Dehiscence from a High Jugular Bulb

Gubbels¹,

Zhang²,

Lenkowski³

et al. 2013

Ann Otol Rhinol Laryngol

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Objective To describe the clinical evaluation and operative management of posterior semicircular canal dehiscence caused by a high jugular bulb. Methods Retrospective case report. Results The patient had clinical and audiometric findings consistent with semicircular canal dehiscence and imaging demonstrating erosion of the posterior semicircular canal by a high jugular bulb. Resurfacing of the eroded canal provided resolution of vestibular symptoms without damage to the inner ear. Conclusions Dehiscence of the posterior semicircular canal can cause clinical and audiometric findings similar to those of superior semicircular canal dehiscence syndrome. Resurfacing of the area of dehiscence can be performed to successfully relieve the vestibular symptoms. In the case of dehiscence of the posterior canal from a high jugular bulb, resurfacing may offer advantages over canal plugging for definitive management.

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“…Haberkamp (1997) found a comparable value of 40% in the bones he studied. Wadin and Wilbrand (1986) noted that up to 24% of patients had high jugular bulbs and that this was often associated with poor temporal bone pneumatisation. Farrior (1942) also noted that in non-pneumatised temporal bones the jugular bulb is often highly-placed.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative assessment to determine the feasibility of the infralabyrinthine approach is therefore mandatory. Computed tomography scanning of the temporal bone is of value in demonstrating the relationship of the jugular bulb to surrounding structures (Wadin and Wilbrand, 1986). Some authors (Villavicencio et al, 2001) also recommend 3-D CT scanning to correctly define bony and vascular landmarks and spatial relationships in deciding the appropriate approach to the PA.…”

Section: Discussionmentioning

confidence: 99%

Infralabyrinthine approach to the petrous apex

Jacob

Rupa

2005

Clin. Anat.

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This study measures the anatomical dimensions of the path to the petrous apex (PA) via the infralabyrinthine approach in temporal bones of adult Indian subjects, and studies the anatomical variation encountered in this approach. Forty-two temporal bones were dissected to gain access to the PA via the infralabyrinthine approach. The horizontal and vertical dimensions of the access window created as well as the length of the track to the PA from the vertical portion of facial nerve were measured with two-point calipers. Complete dissection was possible in only 21 bones (50%). In the remainder, after preliminary cortical mastoidectomy, an access window to the PA could not be created due to a high jugular bulb. The mean dimensions of the window in dissected bones were 4.60 mm vertically (SD = 0.94 mm) and 6.45 mm (SD = 1.44 mm) horizontally, and the depth of the track to the PA was 30.26 mm (SD = 3.62 mm). The infralabyrinthine approach to the PA provides wide access to lesions of the posterior and inferior PA. In up to 50% of temporal bones, as evidenced by this series, access may be limited by a high jugular bulb. The possibility of this anatomical variation should be considered when the surgical approach to a PA lesion via the infralabyrinthine approach is being planned.

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The Topographic Relations of the High Jugular Fossa to the Inner Ear

Cited by 50 publications

References 17 publications

High Computed Tomographic Correlations between Carotid Canal Dehiscence and High Jugular Bulb in the Middle Ear

High Computed Tomographic Correlations between Carotid Canal Dehiscence and High Jugular Bulb in the Middle Ear

Repair of Posterior Semicircular Canal Dehiscence from a High Jugular Bulb

Infralabyrinthine approach to the petrous apex

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