Association Between High Jugular Bulb and Sudden Sensorineural Hearing Loss: A Computed Tomography Based Study

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Sudden sensorineural hearing loss (SSNHL) is an otologic emergency with various potential causes.
• The anatomical variations of the jugular bulb, specifically high jugular bulb (HJB), have been an area of interest in relation to inner ear pathologies.

Purpose of the Study:

• To investigate the correlation between the presence and degree of high jugular bulb (HJB) and the clinical outcomes of patients diagnosed with sudden sensorineural hearing loss (SSNHL).
• To analyze the impact of HJB on hearing recovery and tinnitus severity in SSNHL patients.

Main Methods:

• A cohort of 62 SSNHL patients were analyzed, divided into groups based on the presence or absence of HJB (defined as jugular bulb reaching or exceeding the cochlear base).
• Thin-slice CT, pure tone threshold testing, and tinnitus handicap inventory (THI) were used to assess hearing and tinnitus.
• Statistical analysis was performed to compare outcomes between groups and correlate HJB severity with hearing thresholds and THI scores.

Main Results:

• While both groups showed hearing improvement post-treatment, the non-HJB group exhibited significantly better hearing recovery.
• Pre-treatment tinnitus handicap inventory (THI) scores were significantly higher in the HJB group, with poorer post-treatment outcomes compared to the non-HJB group.
• In the HJB group, higher HJB values correlated with poorer admission and discharge pure tone average (PTA) and THI scores.

Conclusions:

• Patients with SSNHL and a high jugular bulb (HJB) generally experience less favorable hearing recovery.
• HJB is associated with more severe tinnitus and poorer outcomes in sudden sensorineural hearing loss patients.
• The degree of jugular bulb elevation may impact the prognosis of sudden sensorineural hearing loss.