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Jugular bulb phlebectasia
R M Walsh1, F J Lannigan, J A McGlashan
1Department of Otorhinolaryngology, Lewisham Hospital, London, UK.
Insights
Phlebectasia of the internal jugular vein (IJV) is a rare condition causing enlarged neck veins. This case highlights a unique presentation of jugular bulb phlebectasia within the middle ear in a young child.
Area of Science:
- Vascular Surgery
- Pediatric Otolaryngology
- Medical Imaging
Background:
- Phlebectasia of the internal jugular vein (IJV) is a rare congenital venous anomaly.
- Typically presents as a neck mass in young children.
- Characterized by pathological venous enlargement.
Observation:
- A 4-year-old boy presented with a pulsatile blue swelling in his left middle ear.
- The swelling originated from the floor of the middle ear cleft.
- No associated neck symptoms or signs were noted.
Findings:
- Digital subtraction vertebral arteriography (DSVA) and CT scans confirmed jugular bulb phlebectasia.
- The phlebectasia involved the lateral sinus and proximal left IJV.
- A complete bony defect was present in the floor of the middle ear.
Implications:
- This is the first reported case of jugular bulb phlebectasia presenting within the middle ear.
- Highlights the importance of considering venous anomalies in pediatric ear masses.
- The case required no active treatment, suggesting conservative management may be appropriate in select cases.
Abstract:
Phlebectasia of the internal jugular vein (IJV) is a rare venous anomaly that usually presents in young children as a soft cystic swelling in the neck and represents a pathologically enlarged vein. We present a case of jugular bulb phlebectasia in a 4-year-old boy. He presented with a blue pulsatile swelling arising from the floor of the left middle ear cleft. The venous phase of digital subtraction vertebral arteriography (DSVA) and computerised axial tomography (CT) with contrast confirmed a diagnosis of phlebectasia of the lateral sinus and proximal part of the left IJV, with a complete bony defect in the floor of the middle ear. The child did not have any neck symptoms or signs. No active treatment was required. To our knowledge, this is the first case of jugular bulb phlebectasia presenting in the middle ear.