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The relationship between jugular bulb position and jugular bulb related inner ear dehiscence: a retrospective

Jonas J-H Park1, Anmin Shen1, Christina Loberg2

  • 1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.

American Journal of Otolaryngology
|February 22, 2015
PubMed

Insights

High jugular bulb (HJB) is common, but jugular bulb related inner ear dehiscence (JBID) is rare. HJBs extending above the internal acoustic meatus pose the highest risk for dehiscence, particularly affecting the vestibular aqueduct.

Area of Science:

  • Otolaryngology
  • Radiology
  • Anatomy

Background:

  • High jugular bulb (HJB) is an anatomical variation where the jugular bulb extends superiorly.
  • HJB can potentially erode adjacent inner ear structures, leading to jugular bulb related inner ear dehiscence (JBID).

Purpose of the Study:

  • To investigate the relationship between jugular bulb position and the occurrence of JBID.
  • To analyze the specific inner ear structures affected by JBID using high-resolution computed tomography (HRCT).

Main Methods:

  • Retrospective analysis of HRCT scans from 552 ears in 276 patients.
  • Classification of HJB into Type-1 and Type-2 based on jugular bulb dome position relative to the round window and internal acoustic meatus (IAM).
  • Evaluation of JBID frequencies and affected structures, including the vestibular aqueduct (VA), cochlear aqueduct, and posterior semicircular canal.

Main Results:

  • HJB Type-1 and Type-2 were identified in 19% and 15.8% of ears, respectively.
  • JBID was present in 3.8% of all ears, with the vast majority (90.5%) involving erosion of the VA (JBVAD).
  • HJB extending above the IAM showed a significantly higher frequency of JBVAD compared to lower positioned HJBs.

Conclusions:

  • HJB is a frequent finding, while JBID is relatively rare.
  • The vestibular aqueduct is the most commonly eroded structure in cases of JBID.
  • Jugular bulbs positioned above the internal acoustic meatus represent a significant risk factor for developing jugular bulb related vestibular aqueduct dehiscence.
Abstract

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