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A rare cause of conductive hearing loss: High lateralized jugular bulb with bony dehiscence

James G Barr1, Pranay K Singh

  • 1Department of ENT, Guy's and St. Thomas' NHS Foundation Trust, London, UK. jgbarr85@gmail.com.

Ear, Nose, & Throat Journal
|June 16, 2016
PubMed

Insights

A rare cause of pediatric hearing loss was identified: a high jugular bulb. This anatomical variation can lead to conductive hearing loss and requires careful diagnosis to avoid injury.

Area of Science:

  • Otolaryngology
  • Pediatric Medicine
  • Radiology

Background:

  • Conductive hearing loss in children can have various causes.
  • Anatomical variations in the head and neck region can present diagnostic challenges.

Observation:

  • An 8-year-old boy presented with a 40 dB right-sided conductive hearing loss.
  • A visible pink bulge was noted on the inferior aspect of the right tympanic membrane.

Findings:

  • Computed tomography revealed a high, lateralized right jugular bulb with a superolaterally pointing diverticulum.
  • The diverticulum extended into the lower mesotympanum and posterior external auditory meatus.

Implications:

  • Accurate diagnosis of high jugular bulb is crucial to prevent iatrogenic injury to the jugular vein.
  • This rare anomaly necessitates avoiding sharp objects in the ear canal.
  • Highlights the importance of advanced imaging in pediatric ear conditions.

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