A novel approach for surgical repair of dehiscent high jugular bulb

Bilateral high-riding jugular bulb associated with a jugular diverticulum and dehiscence of the mastoid cells and Trautmann’s triangle

“…Aksoy et al reported the same prevalence of bilateral HRJB in 194 children [2]. Shaikh et al reported, according to Chen et al and Huang et al, that DHRJB occurred in 0.5-1.7% [7]. To summarize, we agree with Wang et al [9] that as long as consistency in the de nition of HRJB lacks, the prevalence will be always imprecise.…”

“…The HRJB appears in the otoscopic exam as a bluish mass behind the posterior inferior quadrant of the eardrum. All actions which increase the pressure on the JB, such as the Valsalva maneuver, ipsilateral IJV compression, and supine position, will distend it and facilitate the exam [4,5,7]. When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma.…”

“…When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma. Other tumors may be similar: bluedomed mucosal cyst, paraganglioma, aural polyp, and extramedullary hematopoiesis [7]. It is possible to confuse HRJB with other vascular conditions such as glomus tympanicum or cholesterol granuloma; a well-corticate HRJB may look like a cholesteatoma or neoplasm [6].…”

“…However, a negative otoscopic exam does not exclude the diagnosis, since the JB may uctuate in size from one examination to another [4]. In addition, an opaci ed eardrum, as in chronic middle ear disease, may hide the mass [7]. Likewise, the JBD does not, classically, protrude in the tympanic cavity and consequently is still invisible [5]; its diagnosis is often incidental.…”

Bilateral high-riding jugular bulb associated with a jugular diverticulum and dehiscence of the mastoid cells and Trautmann’s triangle

“…Aksoy et al reported the same prevalence of bilateral HRJB in 194 children [2]. Shaikh et al reported, according to Chen et al and Huang et al, that DHRJB occurred in 0.5-1.7% [7]. To summarize, we agree with Wang et al [9] that as long as consistency in the de nition of HRJB lacks, the prevalence will be always imprecise.…”

“…The HRJB appears in the otoscopic exam as a bluish mass behind the posterior inferior quadrant of the eardrum. All actions which increase the pressure on the JB, such as the Valsalva maneuver, ipsilateral IJV compression, and supine position, will distend it and facilitate the exam [4,5,7]. When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma.…”

“…When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma. Other tumors may be similar: bluedomed mucosal cyst, paraganglioma, aural polyp, and extramedullary hematopoiesis [7]. It is possible to confuse HRJB with other vascular conditions such as glomus tympanicum or cholesterol granuloma; a well-corticate HRJB may look like a cholesteatoma or neoplasm [6].…”

“…However, a negative otoscopic exam does not exclude the diagnosis, since the JB may uctuate in size from one examination to another [4]. In addition, an opaci ed eardrum, as in chronic middle ear disease, may hide the mass [7]. Likewise, the JBD does not, classically, protrude in the tympanic cavity and consequently is still invisible [5]; its diagnosis is often incidental.…”

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

“…It may be asymptomatic or may cause tinnitus and conductive hearing loss. [10,11] Conductive hearing loss was present in 2 of our cases with DMJB. The other 4 cases had otitis, ear pain, and tinnitus in their physical examinations.…”

Bilateral high-riding jugular bulb associated with a jugular diverticulum and dehiscence of the mastoid cells and Trautmann’s triangle

“…Aksoy et al reported the same prevalence of bilateral HRJB in 194 children [2]. Shaikh et al reported, according to Chen et al and Huang et al, that DHRJB occurred in 0.5-1.7% [7]. To summarize, we agree with Wang et al [9] that as long as consistency in the de nition of HRJB lacks, the prevalence will be always imprecise.…”

“…The HRJB appears in the otoscopic exam as a bluish mass behind the posterior inferior quadrant of the eardrum. All actions which increase the pressure on the JB, such as the Valsalva maneuver, ipsilateral IJV compression, and supine position, will distend it and facilitate the exam [4,5,7]. When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma.…”

“…When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma. Other tumors may be similar: bluedomed mucosal cyst, paraganglioma, aural polyp, and extramedullary hematopoiesis [7]. It is possible to confuse HRJB with other vascular conditions such as glomus tympanicum or cholesterol granuloma; a well-corticate HRJB may look like a cholesteatoma or neoplasm [6].…”

“…However, a negative otoscopic exam does not exclude the diagnosis, since the JB may uctuate in size from one examination to another [4]. In addition, an opaci ed eardrum, as in chronic middle ear disease, may hide the mass [7]. Likewise, the JBD does not, classically, protrude in the tympanic cavity and consequently is still invisible [5]; its diagnosis is often incidental.…”

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

“…It may be asymptomatic or may cause tinnitus and conductive hearing loss. [10,11] Conductive hearing loss was present in 2 of our cases with DMJB. The other 4 cases had otitis, ear pain, and tinnitus in their physical examinations.…”

Bilateral high-riding jugular bulb associated with a jugular diverticulum and dehiscence of the mastoid cells and Trautmann’s triangle

“…Aksoy et al reported the same prevalence of bilateral HRJB in 194 children [2]. Shaikh et al reported, according to Chen et al and Huang et al, that DHRJB occurred in 0.5-1.7% [7]. To summarize, we agree with Wang et al [9] that as long as consistency in the de nition of HRJB lacks, the prevalence will be always imprecise.…”

“…The HRJB appears in the otoscopic exam as a bluish mass behind the posterior inferior quadrant of the eardrum. All actions which increase the pressure on the JB, such as the Valsalva maneuver, ipsilateral IJV compression, and supine position, will distend it and facilitate the exam [4,5,7]. When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma.…”

“…When HRJB manifests as a bluish mass, the differential diagnosis involves vascular conditions which appear the same; it includes the internal carotid artery aberrance or diverticulum, eardrum phlebectasia, and hemangioma. Other tumors may be similar: bluedomed mucosal cyst, paraganglioma, aural polyp, and extramedullary hematopoiesis [7]. It is possible to confuse HRJB with other vascular conditions such as glomus tympanicum or cholesterol granuloma; a well-corticate HRJB may look like a cholesteatoma or neoplasm [6].…”

“…However, a negative otoscopic exam does not exclude the diagnosis, since the JB may uctuate in size from one examination to another [4]. In addition, an opaci ed eardrum, as in chronic middle ear disease, may hide the mass [7]. Likewise, the JBD does not, classically, protrude in the tympanic cavity and consequently is still invisible [5]; its diagnosis is often incidental.…”

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

“…It may be asymptomatic or may cause tinnitus and conductive hearing loss. [10,11] Conductive hearing loss was present in 2 of our cases with DMJB. The other 4 cases had otitis, ear pain, and tinnitus in their physical examinations.…”