Effects of a High Jugular Fossa and Jugular Bulb Diverticulum on the Inner Ear

Abstract

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Menière's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiographed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

High jugular bulb in a cohort of patients with definite Ménière's disease

“…In our population of patients diagnosed with definite Ménière's disease, the observed incidence of high jugular bulb (57.1 per cent) is greater than expected based on previous studies 1 , 5 , 8 – 10 . A high jugular bulb is reported to be more common in the right ear 5 .…”

High jugular bulb in a cohort of patients with definite Ménière's disease

“…In our population of patients diagnosed with definite Ménière's disease, the observed incidence of high jugular bulb (57.1 per cent) is greater than expected based on previous studies 1 , 5 , 8 – 10 . A high jugular bulb is reported to be more common in the right ear 5 .…”

Relationship of Vestibular Aqueduct and Inner Ear Pressure in Ménière's Disease and the Normal Population

“…A histologic relationship between a high jugular bulb and endolymphatic sac was reported recently by Kawano et al 19 They demonstrated a bony dehiscence between the jugular bulb and the endolymphatic sac histologically on the lateral wall of the endolymphatic sac. However, there was no evidence of compression of the endolymphatic sac.…”

High Jugular Bulb and Conductive Hearing Loss

“…In the Zorzetto and Tamega study of 54 temporal bone specimens with high jugular bulbs, they observed encroachment of the round window niche in each case, ranging from partial to complete obstruction 16 . Wadin et al reported radiographic evidence of round window encroachment in 24% of the unselected cases in their series 13 . These observations and the case material suggest that round window obstruction is a leading mechanism for conductive hearing loss by a high jugular bulb.…”

High jugular bulb in a cohort of patients with definite Ménière's disease

“…In our population of patients diagnosed with definite Ménière's disease, the observed incidence of high jugular bulb (57.1 per cent) is greater than expected based on previous studies 1 , 5 , 8 – 10 . A high jugular bulb is reported to be more common in the right ear 5 .…”

Relationship of Vestibular Aqueduct and Inner Ear Pressure in Ménière's Disease and the Normal Population

“…A histologic relationship between a high jugular bulb and endolymphatic sac was reported recently by Kawano et al 19 They demonstrated a bony dehiscence between the jugular bulb and the endolymphatic sac histologically on the lateral wall of the endolymphatic sac. However, there was no evidence of compression of the endolymphatic sac.…”

High Jugular Bulb and Conductive Hearing Loss

“…In the Zorzetto and Tamega study of 54 temporal bone specimens with high jugular bulbs, they observed encroachment of the round window niche in each case, ranging from partial to complete obstruction 16 . Wadin et al reported radiographic evidence of round window encroachment in 24% of the unselected cases in their series 13 . These observations and the case material suggest that round window obstruction is a leading mechanism for conductive hearing loss by a high jugular bulb.…”

High jugular bulb in a cohort of patients with definite Ménière's disease

“…In our population of patients diagnosed with definite Ménière's disease, the observed incidence of high jugular bulb (57.1 per cent) is greater than expected based on previous studies 1 , 5 , 8 – 10 . A high jugular bulb is reported to be more common in the right ear 5 .…”

Relationship of Vestibular Aqueduct and Inner Ear Pressure in Ménière's Disease and the Normal Population

“…A histologic relationship between a high jugular bulb and endolymphatic sac was reported recently by Kawano et al 19 They demonstrated a bony dehiscence between the jugular bulb and the endolymphatic sac histologically on the lateral wall of the endolymphatic sac. However, there was no evidence of compression of the endolymphatic sac.…”

High Jugular Bulb and Conductive Hearing Loss

“…In the Zorzetto and Tamega study of 54 temporal bone specimens with high jugular bulbs, they observed encroachment of the round window niche in each case, ranging from partial to complete obstruction 16 . Wadin et al reported radiographic evidence of round window encroachment in 24% of the unselected cases in their series 13 . These observations and the case material suggest that round window obstruction is a leading mechanism for conductive hearing loss by a high jugular bulb.…”