Conductive Hearing Loss and the Jugular Bulb

Toman, J; Wu, Xiao; Malhotra, Ajay; Michaelides, Elias

doi:10.1007/s00062-015-0436-5

Cited by 5 publications

(12 citation statements)

References 21 publications

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“…[ 1 ] Its size and location vary among individuals, and anomalies are frequently seen on otoscopy, during surgery, or in imaging studies. [ 7 ] Several definitions of HRJB have been proposed, [ 1 , 3 – 6 ] with the incidence ranging from 6% to 34%, and that of a dehiscent jugular bulb reported as 3.9%. [ 1 , 2 , 4 , 6 , 8 – 11 ] Because the jugular vein and dural sinuses are larger on the right, HRJB has a right-sided predominance.…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 ] Several definitions of HRJB have been proposed, [ 1 , 3 – 6 ] with the incidence ranging from 6% to 34%, and that of a dehiscent jugular bulb reported as 3.9%. [ 1 , 2 , 4 , 6 , 8 – 11 ] Because the jugular vein and dural sinuses are larger on the right, HRJB has a right-sided predominance. [ 4 , 6 , 11 ] On physical examination, it can be confused with vascular and nonvascular masses, and when covered by bone, its whitish appearance causes it to resemble a cholesteatoma.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 , 2 , 4 , 6 , 8 – 11 ] Because the jugular vein and dural sinuses are larger on the right, HRJB has a right-sided predominance. [ 4 , 6 , 11 ] On physical examination, it can be confused with vascular and nonvascular masses, and when covered by bone, its whitish appearance causes it to resemble a cholesteatoma. HJRB may also appear as a red, blue, or purplish discoloration in the posteroinferior quadrant of the TM, in which case, it will resemble a hypervascular tumor such as glomus tympanicum, a hemorrhage, or a cholesterol granuloma.…”

Section: Discussionmentioning

confidence: 99%

“…[ 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%). [ 9 ] In those patients with sensorineural hearing loss, the mechanism is thought to involve and compress the vestibular aqueduct.…”

Section: Discussionmentioning

confidence: 99%

“…The possible mechanisms of CHL related to dehiscent HRJB included contact with the tympanic membrane (TM), interfering the ossicles, and involvement of the round window. [ 1 , 3 , 5 , 6 ] There were several case reports describing the association between HRJB and CHL, which showed only some part of known mechanisms. Here, we present the case of a child with CHL related to a dehiscent HRJB, presenting all the proposed attributable mechanisms on temporal bone computed tomography (TBCT).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dehiscent high-riding jugular bulb presenting as conductive hearing loss

Koo

Lee²,

Lee³

et al. 2018

Medicine

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Dual retrotympanic aural mass

2021

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High-riding jugular bulb (HRJB), although rare, may pose a challenge as it may be mistaken for other non-alarming condition, such as middle ear effusion. Patients with HRJB classically present with pulsatile tinnitus. We report a unique case of a 26-year-old patient with underlying beta thalassaemia who presented with a 2-month history of intermittent epistaxis and rhinorrhoea. Otoscopic examinations revealed a pulsatile bluish mass behind the right tympanic membrane and a dull left tympanic membrane. Imaging performed revealed a finding of dual retrotympanic pathology, which consisted of a right dehiscent HRJB and left cholesterol granuloma. We highlight a rare case of dual retrotympanic mass as well as its management.

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Cholesteatoma Surgery With a Dehiscent High Jugular Bulb Treated With Surgery Assisted With Underwater Endoscopy: A Case Report

et al. 2021

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A dehiscent high jugular bulb would be a pitfall in middle ear surgery especially for cholesteatoma. We report a case of cholesteatoma attached to a dehiscent high jugular bulb successfully treated with surgery assisted with underwater endoscopy. To the best of our knowledge, no previous study has reported a case of cholesteatoma with dehiscent high jugular bulb treated with surgery assisted with underwater endoscopy. Owing to the risk of jugular bulb injury, underwater endoscopy is a good indication for middle ear cases with a dehiscent high jugular bulb to obtain a clear operative field and avoid an unexpected air embolism.

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Conductive Hearing Loss and the Jugular Bulb

Cited by 5 publications

References 21 publications

Dehiscent high-riding jugular bulb presenting as conductive hearing loss

Dehiscent high-riding jugular bulb presenting as conductive hearing loss

Dual retrotympanic aural mass

Cholesteatoma Surgery With a Dehiscent High Jugular Bulb Treated With Surgery Assisted With Underwater Endoscopy: A Case Report

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