A novel approach for surgical repair of dehiscent high jugular bulb

Shaikh, Mohammad F.; Mahboubi, Hossein; German, Michael; Djalilian, Hamid R.

doi:10.1002/lary.23891

Cited by 13 publications

(20 citation statements)

References 22 publications

(34 reference statements)

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“…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.…”

Section: Discussionmentioning

confidence: 79%

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

Burakgazi¹,

Bayaroğulları²

2020

Anatomy

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Objectives: Tympanic cavity (TC) is an anatomically challenging region for the diagnosis of lesions located inside it. Radiological diagnosis and demonstration of the anatomic localization of sporadic lesions such as vascular malformations and meningocele are essential for the prevention of complications that may occur during operation and recurrent unnecessary interventions. The aim of the present study was to demonstrate the radiological appearance of the vascular variations and the post-traumatic soft tissue lesions which are rarely encountered in TC. Methods: A total of 3525 temporal multi-slice computed tomography (MSCT) images were evaluated between 2010–2018. Twelve cases with non-inflamatory and non-neoplastic soft tissue lesions in TC were detected and 2 with meningocele were included in the study. Results: Of the 12 cases, 6 were males and 6 were females. The mean age of the patients was 26.16 years. Four cases had an aberrant internal carotid artery (ICA), being bilateral in 2 cases and right sided in the remaining 2 cases. Six cases had dehiscent mega jugular bulb (DMJB); and 2 cases had post-traumatic meningocele. Conclusion: Vascular malformations and meningoceles are rarely observed in TC. They may present nonspecific clinical signs and symptoms; however, they should be evaluated with MSCT and MRI before the surgical interventions regarding the middle ear to prevent possible complications.

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Section: Discussionmentioning

confidence: 79%

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

Burakgazi¹,

Bayaroğulları²

2020

Anatomy

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“…As for the treatments reported for DHJB, pulsatile tinnitus was ameliorated in 5/7 cases using autologous tissue [5]. There have also been case reports about the amelioration of tinnitus using hydroxyapatite as a reconstructive material (in 3/3 patients) and the improvement of conductive hearing loss using Gelfoam V R [6,7]. In addition, compression of the sigmoid sinus to change the patient's hemodynamic status ameliorated hearing loss in 1/2 of patients [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Various surgical treatments for DHJB, such as compression of the JB with autologous tissue or hydroxyapatite cement or endovascular treatment, have been reported [5][6][7][8][9]. We report the case of a patient who presented with conductive hearing loss due to a DHJB in her only hearing ear.…”

Section: Introductionmentioning

confidence: 99%

Tympanic floor reconstruction for conductive hearing loss due to a dehiscent high jugular bulb in the only hearing ear

Teramura

Kakigi

Takano

et al. 2021

Acta Oto-Laryngologica Case Reports

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A 10-year-old girl with left-sided congenital deafness, who was treated for recurrent otitis media effusion, presented with conductive hearing loss in her only hearing ear. Otoscopy showed a blue mass in the tympanic cavity, and a dehiscent high jugular bulb (DHJB) was diagnosed. Computed tomography showed that the jugular bulb (JB) was located above the inferior wall of the tympanic cavity and was in contact with the tympanic membrane and obstructing the round window niche. The patient underwent surgical fixation of the DHJB and reconstruction of the tympanic floor with a tragus cartilage autograft. Two years after the operation, the JB was still situated in an appropriate location, and the patient's hearing had improved. Observation is one of the management options for DHJB. However, surgical treatment should be considered for DHJB, even if the patient only has one hearing ear.

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“…The clinical significance of HRJB is that it can cause fatal hemorrhage because of inadvertent puncture in patients undergoing myringotomy or tympanoplasty. [ 7 , 8 – 10 ] Although in most cases, HRJB is incidentally detected, a small number of patients may suffer hearing loss, tinnitus, and vertigo. [ 1 – 4 , 6 ] Tinnitus is the most common symptom (50.4%), whereas hearing disturbance is rare (1.9%).…”

Section: Discussionmentioning

confidence: 99%

Dehiscent high-riding jugular bulb presenting as conductive hearing loss

Koo

Lee²,

Lee³

et al. 2018

Medicine

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Rationale:Jugular bulb anomalies are asymptomatic lesions commonly seen in routine practice. However, some patients with jugular bulb anomalies may present with symptoms such as tinnitus or conductive hearing loss (CHL).Patient concerns:A 9 year old boy complained right sided hearing disturbance without any vestibular symptoms. Pure tone audiometry (PTA) revealed a mild right sided conductive hearing loss. Otoscopy showed a red-purplish mass like lesion in his right middle ear cavity, which was regarded as hypervascular tumor.Diagnosis:Based on otoscopic findings, preliminary differential diagnoses included jugular bulb anomaly, hemotympanum, cholesterol granuloma and paraganglioma.Interventions:We performed contrast enhanced computed tomography of the temporal bone (TBCT).Outcomes:CT scan showed and enhancing lesion which was bulging from his right jugular foramen to the middle ear with dehiscent jugular bulb. The lesion showed the same degree of contrast enhancement with the venous vasculature. This lesion contacted with the tympanic membrane, incudostapedial joint and round window, which might be attributable to interruption of sound transmission mechanics. Otherwise there was no evidence of mass or trauma related lesions in the temporal bone.Lessons:Although most of jugular bulb anomalies are asymptomatic, patients may present with conductive hearing loss due to the interference of sound transmission mechanics.

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A novel approach for surgical repair of dehiscent high jugular bulb

Cited by 13 publications

References 22 publications

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

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

Tympanic floor reconstruction for conductive hearing loss due to a dehiscent high jugular bulb in the only hearing ear

Dehiscent high-riding jugular bulb presenting as conductive hearing loss

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