European Archives of Oto-Rhino-Laryngology

, Volume 256, Issue 5, pp 224–229

Surgical treatment of the high jugular bulb in patients with Ménière’s disease and pulsatile tinnitus

  • V. Couloigner
  • A. Bozorg Grayeli
  • D. Bouccara
  • N. Julien
  • O. Sterkers
Neuro-otology

DOI: 10.1007/s004050050146

Cite this article as:
Couloigner, V., Bozorg Grayeli, A., Bouccara, D. et al. European Archives of Oto-Rhino-Laryngology (1999) 256: 224. doi:10.1007/s004050050146

Abstract

The aim of this retrospective study was to evaluate the functional results of surgical lowering of the high jugular bulb in the treatment of patients with Ménière’s disease and pulsatile tinnitus. Fifteen patients with disabling Ménière’s disease associated with pulsatile tinnitus and a high and medial jugular bulb were included in this study. As treatment a complete mastoidectomy was performed, after which the jugular bulb was freed by an infralabyrinthine and subfacial approach. The bulb was then displaced downwards with surgical wax. Functional results of surgery were assessed by a questionnaire according to the 1995 guidelines of the United States American Academy Committee on Hearing and Equilibrium, audiometric and vestibular tests, and by magnetic resonance and computed tomographic imaging with vascular sequences. Surgical treatment was contraindicated in two cases: one had hypoplasia of the contralateral sigmoid sinus and the other a small petrous hemangioma located around the jugular bulb that was discovered peroperatively. Among the 13 patients treated by definitive surgery, attacks of vertigo were reported as disabling in 12 cases preoperatively (92%) versus 1 (8%) after surgical treatment. No significant change in hearing was observed after surgery. Tinnitus had been reported in all patients preoperatively and decreased in intensity in four (31%) and disappeared in three (23%) after surgery.

Key words Ménière’s disease High jugular bulb Endolymphatic sac Pulsatile tinnitus Surgical treatment of the jugular bulb 

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • V. Couloigner
    • 1
  • A. Bozorg Grayeli
    • 1
  • D. Bouccara
    • 1
  • N. Julien
    • 1
  • O. Sterkers
    • 1
  1. 1.Department of Otolaryngology Head and Neck Surgery, AP-HP, Hôpital Beaujon, 100, Boulevard du Général Leclerc, F-92118 Clichy Cedex, FranceFR

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