Abstract
Purpose
The purpose of this investigation was to compare the rate of high jugular bulb (HJB) in relation to internal acoustic meatus (IAM), round window (RW) and endolymphatic sac and to study their clinical implications.
Methods
Eighty-seven cadaveric non-pathologic human temporal bones were micro-dissected to expose the jugular fossa (JF) and RW. The minimum distance of JF from RW was measured. On the inner surface of petrous part of temporal bone, minimum vertical distance of JF from IAM and saccus endolymphaticus (E sac) was also measured. If the distance of summit of JF from RW or IAM was ≤2 mm or if there was no distance between JF and slit on which E sac opens, they were classified as HJB cases.
Results
The mean minimum distance of JF from the RW, IAM and E sac was found to be 2.85 ± 1.58, 3.83 ± 2.38 and 2.06 ± 2.38 mm and the rate of HJB was 32.2, 24.1 and 41.4 % respectively.
Conclusions
The rate of HJB varies even in a particular specimen using different landmarks i.e. the RW, IAM and E sac. The preoperative awareness in relation to these landmarks will be useful in cochlear implantation, surgical removal of vestibular schwanommas and clinical findings of Meniere’s disease.
References
Aquino JEP, Cruz Filho NA, Cruz NA (1999) Bulbo da jugular anômalo na caixa do tímpano: estudo sobre sete casos. Rev Bras Otorrinolaringol 65:85–90
Ball M, Elloy M, Vaidhyanath R, Pau H (2010) Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal. J Laryngol Otol 124:790–792
Dai PD, Zhang HQ, Wang ZM, Sha Y, Wang KQ, Zhang TY (2007) Morphological and positional relationships between the sigmoid sinus and the jugular bulb. Surg Radiol Anat 29:643–651
Duan JR, Luo HQ, Lu CJ, Wei JP, Li MZ, Xiong JP (2004) Round window area temporal bone section versus CT (article in Chinese). Zhonghua Er Bi Yan Hou Ke Za Zhi 39:269–272
El-Begermy MA, Rabie AN (2010) A novel surgical technique for management of tinnitus due to high dehiscent jugular bulb. Otolaryngol Head Neck Surg 142:576–581
Friedmann DR, Eubig J, Winata LS, Pramanik BK, Merchant SN, Lalwani AK (2012) A clinical and histopathologic study of jugular bulb abnormalities. Arch Otolaryngol Head Neck Surg 138:66–71
Gejrot T (1964) Retrograde jugularography in the diagnosis of abnormalities of the superior bulb of the internal jugular vein. Acta Otolaryngol 57:177–180
Goravalingappa R (2002) Cochlear implant electrode insertion: Jacobson’s nerve, a useful anatomical landmark. Indian J Otolaryngol Head Neck Surg 54:70–73
Graham MD (1977) The jugular bulb: its anatomic and clinical considerations in contemporary otology. Laryngoscope 87:105–125
Gupta T, Gupta SK (2009) Anatomical delineation of a safety zone for drilling the internal acoustic meatus during surgery for vestibular schwanomma by retrosigmoid suboccipital approach. Clin Anat 22(7):794–799
Hourani R, Carey J, Yousem DM (2005) Dehiscence of the jugular bulb and vestibular aqueduct: findings on 200 consecutive temporal bone computed tomography scans. J Comput Assist Tomogr 29:657–662
Kennedy DW, Hafez-El-Sirsy H, Nager GT (1986) The jugular bulb in otologic surgery: anatomic, clinical and surgical considerations. Otolaryngol Head Neck Surg 94:6–15
Kim MJ, Kwack BG, Cha HE, Han GC (2013) Jugular bulb diverticulum mimicking Meniere’s disease: case report. Int Adv Otol 9(1):135–139
Kuhn MA, Friedmann DR, Winata LS, Eubig J, Pramanik BK, Kveton J et al (2012) Large jugular bulb abnormalities involving the middle ear. Otol Neurotol 33:1201–1206
Moore PJ (1994) The high jugular bulb in ear surgery: three case reports and a review of the literature. J Laryngol Otol 108:772–775
Orr JB, Todd NW (1988) Jugular bulb position and shape are unrelated to temporal bone pneumatization. Laryngoscope 98:136–138
Overton SB, Ritter FN (1973) A high placed jugular bulb in the middle ear: a clinical and temporal bone study. Laryngoscope 83:1986–1991
Page JR (1914) A case of probable injury to the jugular bulb following myringotomy in an infant 10 months old. Ann Otol Rhino Laryngol 23:161–163
Rauch SD, Xu W, Nadol JB (1993) High jugular bulb: implications for posterior fossa neurotologic and cranial base surgery. Ann Otol Rhinol Laryngol 102:100–107
Talas DU, Kurtoglu Z, Koseoglu A, Uzmansel D, Ozturk H, Bagdatoglu C (2008) The variations of temporal bone neurovascular structures in otologic-neurotologic surgeries: a cadaver dissection study. Int Adv Otol 4:157–163
Vachata P, Petrovicky P, Sames M (2010) An anatomical and radiological study of the high jugular bulb on high-resolution CT scans and alcohol-fixed skulls of adults. J Clin Neurosci 17:473–478
Wadin K, Thomander L, Wilbrand H (1986) Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation. Acta radiol Diagn (Stockh) 27:629–636
Wadin K, Wilbrand H (1986) The topographic relations of the high jugular fossa to the inner ear. A radioanatomic investigation. Acta Radiol Diagn (Stockh) 27:315–324
Wadin K, Wilbrand H (1986) The jugular bulb diverticulum. A radioanatomic investigation. Acta Radiol Diagn (Stockh) 27:395–401
Wang CH, Shi ZP, Liu DP, Wang HW, Huang BR, Chen HC (2011) High computed tomographic correlations between carotid canal dehiscence and high jugular bulb in the middle ear. Audiol Neurootol 16:106–112
West JM, Bandy BC, Jafek BW (1974) Aberrant jugular bulb in middle ear cavity. Arch Otolaryngol 100:370–372
Wysocki J, Skarzynski H (1998) Distance between the cochlea and adjacent structures related to cochlear implant surgery. Surg Radiol Anat 20:267–271
Yazawa Y, Suzuki M, Tanaka H, Kitano H, Kitajima K (1998) Surgical observations on the endolymphatic sac in Meniere’s disease. Am J Otol 19(1):71–75
Zhen J, Liu C, Wang S, Liu S, He J, Wang J, Chen H (2007) The thin sectional anatomy of the temporal bone correlated with multislice spiral CT. Surg Radiol Anat 29:409–418
Acknowledgments
The authors sincerely thank Mr Vijay Kant Bakshi and Mr Pradeep for skillful photography and Mr Puneet Singal for his help in data analysis. Authors are also thankful to the cadavers and their family members for donation of their bodies. May their soul live in peace. The study was supported by a Grant from the Indian Council of Medical Research, New Delhi, India (Grant No. 51/2/2011-BMS).
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Singla, A., Gupta, T., Sahni, D. et al. High jugular bulb: different osseous landmarks and their clinical implications. Surg Radiol Anat 38, 903–909 (2016). https://doi.org/10.1007/s00276-016-1649-2
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DOI: https://doi.org/10.1007/s00276-016-1649-2