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Jugular bulb anatomical variations and pneumatization patterns: a comprehensive CBCT analysis.

Răzvan Costin Tudose1, Mugurel Constantin Rusu2,3, George Triantafyllou4

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Summary

This study classified jugular bulb (JB) pneumatization patterns, revealing that hypotympanum (HT) significantly increases the distance to the internal acoustic canal (IAC). These findings enhance understanding of temporal bone anatomy and surgical considerations.

Keywords:
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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Radiology

Background:

  • The jugular bulb (JB) is a critical anatomical structure in the temporal bone.
  • Variations in JB pneumatization can impact surgical approaches and patient outcomes.
  • Understanding JB anatomy is essential for procedures involving the skull base.

Purpose of the Study:

  • To assess the anatomical variations and possibilities of the jugular bulb (JB).
  • To classify different patterns of JB pneumatization.
  • To evaluate the relationship between JB pneumatization and the internal acoustic canal (IAC) distance.

Main Methods:

  • Analysis of 50 archived cone-beam computed tomography (CBCT) scans.
  • Classification of JB wall pneumatization into eight distinct patterns.
  • Measurement of the distance between the IAC and the JB.

Main Results:

  • The average IAC-JB distance was 7.97 mm bilaterally.
  • Deep petrosal cells (DPCs) were common, while medial wall pneumatization was rare.
  • Hypotympanum (HT) pneumatization significantly increased IAC-JB distance (average 4.67 mm increase vs. no pneumatization).
  • Other variations included accessory occipital cells (AOCs), JB hypoplasia/hyperplasia, diverticula, dehiscence, and high JBs.

Conclusions:

  • A novel classification system for JB pneumatizations was established.
  • Specific pneumatization patterns, particularly HT, significantly influence IAC-JB distance.
  • This classification aids in understanding temporal bone anatomy and potential surgical risks.