Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T14:19:01.206Z Has data issue: false hasContentIssue false
  • English
  • Français

Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal

Published online by Cambridge University Press:  22 December 2009

M Ball ,
M Elloy ,
R Vaidhyanath  and
H Pau
M Ball*
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
M Elloy
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
R Vaidhyanath
Affiliation:
Department of Radiology, Leicester Royal Infirmary, UK
H Pau
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
*
Address for correspondence: Miss Mary Ball, Department of Otolaryngology, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK. Fax: 0116 258 6082 E-mail: maryball@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We report two rare cases of high and dehiscent jugular bulbs protruding into the external ear canal; one case was silent, the other symptomatic.

Method:

The cases are presented and the relevant literature reviewed and discussed.

Results:

A 52-year-old woman underwent mastoid exploration for suspected cholesteatoma. On raising the tympanomeatal flap, while still lateral to the annulus, brisk venous bleeding occurred from a high, dehiscent jugular bulb in the external ear canal. The second patient, a 42-year-old man, underwent imaging for suspected glomus tumour. A high, dehiscent jugular bulb was found protruding into the external ear canal and hypotympanum.

Conclusion:

High jugular bulbs in the middle ear have been reported many times. To our knowledge, there has only been one previous report of a high jugular bulb in the external ear. These cases illustrate the importance of full, accurate assessment of high resolution computed tomography images, and of appropriate, immediate management of bleeding.

Keywords

Case ReportJugular, DehiscenceRadiology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 7 , July 2010 , pp. 790 - 792
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Atilla, S, Akpek, S, Uslu, S, Ilgit, ET, Işik, S. Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol 1995;20:52–6CrossRefGoogle ScholarPubMed
2Harnsberger, R, Hudgens, P, Wiggins, R, Davidson, C. Dehiscent jugular bulb. In: Harnsberger, R et al. Diagnostic Imaging: Head and Neck, 3rd edn.Salt Lake City, Utah: Amirsys/Elsevier Saunders, 2006;18–22Google Scholar
3Moore, P. The high jugular bulb in ear surgery: three case reports and a review of the literature. J Laryngol Otol 1994;108:772–5CrossRefGoogle Scholar
4Towbin, RB, Ball, WS, Benton, C, Han, BK. Paediatric case of the day. I. Dehiscent jugular bulb. II. Mondini malformation. III. Aural atresia. Radiographics 1988;8:1221–6CrossRefGoogle Scholar
5Ford, KL. Aunt Minnie's corner. High-riding jugular bulb. J Comput Assist Tomogr 1998;22:508CrossRefGoogle ScholarPubMed
6Tomura, N, Sashi, R, Kobayashi, M, Hirano, H, Hashimoto, M, Watarai, J. Normal variations of the temporal bone on high-resolution CT: their incidence and clinical significance. Clin Radiol 1995;50:144–8CrossRefGoogle ScholarPubMed
7Koesling, S, Kunkel, P, Schul, T. Vascular anomalies, sutures and small canals of the temporal bone on axial CT. Eur J Radiol 2005;54:335–43CrossRefGoogle ScholarPubMed
8Subotić, R. The high position of the jugular bulb. Acta Otolaryngol 1979;87:340–4CrossRefGoogle ScholarPubMed