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Radiologic analysis of high jugular bulb by computed tomography
Chang-Ki Woo1, Chan-Eun Wie, Sung-Hwan Park
1Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan, Republic of Korea.
Summary
High jugular bulb (HJB) affects 9.5% of ears, with 27.8% showing bony dehiscence. Awareness of HJB and dehiscence is crucial for preventing surgical complications.
Area of Science:
- Otolaryngology
- Radiology
- Anatomy
Background:
- Previous high jugular bulb (HJB) studies often lacked scale or focused narrowly on incidence.
- High-resolution temporal bone computed tomography (CT) enables large-scale investigation of HJB and associated bony dehiscence.
Purpose of the Study:
- To determine the incidence of HJB and bony dehiscence using temporal bone CT.
- To measure HJB dimensions (horizontal distance, vertical height) relative to the tympanic annulus.
- To classify HJB based on its position relative to surrounding anatomical structures.
Main Methods:
- Retrospective review of 4,598 temporal bone CT scans (2005-2010).
- Exclusion of pediatric patients, prior ear surgery, cholesteatoma, adhesive otitis media, and congenital anomalies.
- Classification of HJB into three groups (A, B, C) based on proximity to the cochlear basal turn and lateral semicircular canal.
Main Results:
- HJB was found in 9.5% of ears (435/4,598), more common on the right side.
- Bony dehiscence of HJB occurred in 27.8% of HJB cases (121/435), also more frequent on the right.
- Average horizontal distance to tympanic annulus was 2.2 mm; 10.8% of HJB cases contacted the tympanic membrane. Group B was the most common classification (62.1%).
Conclusions:
- A significant percentage of high jugular bulb cases exhibit bony dehiscence, with some contacting the tympanic membrane.
- The findings underscore the importance of considering HJB and bony dehiscence in surgical planning to prevent inadvertent injuries.
- Accurate anatomical assessment via CT is vital for managing HJB-related risks.
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