Management of Jugular Bulb Injuries during Endoscopic Ear Surgery: Our Experience

Ferri, Gaetano; Fermi, Matteo; Alicandri‐Ciufelli, Matteo; Villari, Domenico; Presutti, Livio

doi:10.1055/s-0039-1677679

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…In middle and inner ear surgery, a high-riding JB can limit the access to the surgical target and the maneuverability of the instruments. This can negatively affect the operative outcome and increase the risk of inadvertent injury [1,3]. Therefore, preoperative determination of the height of the JB is of utmost importance for the planning of surgical procedures [5].…”

Section: Introductionmentioning

confidence: 99%

Assessment of jugular bulb variability based on 3D surface models: quantitative measurements and surgical implications

et al. 2023

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Purpose High-riding jugular bulbs (JBs) among other anatomical variations can limit surgical access during lateral skull base surgery or middle ear surgery and must be carefully assessed preoperatively. We reconstruct 3D surface models to evaluate recent JB classification systems and assess the variability in the JB and surrounding structures. Methods 3D surface models were reconstructed from 46 temporal bones from computed tomography scans. Two independent raters visually assessed the height of the JB in the 3D models. Distances between the round window and the JB dome were measured to evaluate the spacing of this area. Additional distances between landmarks on surrounding structures were measured and statistically analyzed to describe the anatomical variability between and within subjects. Results The visual classification revealed that 30% of the specimens had no JB, 63% a low JB, and 7% a high-riding JB. The measured mean distance from the round window to the jugular bulb ranges between 3.22 ± 0.97 mm and 10.34 ± 1.41 mm. The distance measurement (error rate 5%) was more accurate than the visual classification (error rate 15%). The variability of the JB was higher than for the surrounding structures. No systematic laterality was found for any structure. Conclusion Qualitative analysis in 3D models can contribute to a better spatial orientation in the lateral skull base and, thereby, have important implications during planning of middle ear and lateral skull base surgery.

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Section: Introductionmentioning

confidence: 99%

Assessment of jugular bulb variability based on 3D surface models: quantitative measurements and surgical implications

et al. 2023

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“…High riding jugular bulb (HJB) is a vascular abnormality which is characterized by the higher-than-normal location of the jugular bulb. First defined by Page (2) HJB usually remains asymptomatic; however, it is of clinical importance for a few reasons: (i) HJB can cause conductive hearing loss, pulsatile tinnitus, vestibular dysfunction, and ear fullness particularly when bony dehiscence occurred (3); and (ii) due to its close proximity to inner ear canal, during ear surgery it can be inadvertently injured with ensuing serious bleeding (4).…”

Section: Introductionmentioning

confidence: 99%

High riding jugular bulb: prevalence and significance in asymptomatic children

Aksoy¹,

Yurdaışık

2022

Acta Radiol

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Background High riding jugular bulb (HJB) is a vascular abnormality characterized by the higher-than-normal location of the jugular bulb. Purpose To evaluate the frequency of HJB among children who underwent cranial computed tomography (CT) mostly because of head trauma. Material and Methods Patient demographics such as age, sex, indication of cranial CT, diameters of the right and left JB, and presence and laterality of HJB were recorded and analyzed. Patients were grouped as with HJB and without HJB; the variables were compared between these two groups. Patients were also divided into age groups as 0–1 month, 1–12 months, 12–24 months, and >24 months and the findings. The Shapiro–Wilk test, histograms, and Q-Q, Mann–Whitney U-test, Pearson's chi-square test, and Fisher's exact test were used. Results In total, CT images of 194 patients (388 JBs) were evaluated. Overall, 42.8% of children had HJB. Only three children had bilateral HJB. Of all JBs, 22.2% were high riding. Children who did not have HJB were significantly younger compared to children with HJB ( P = 0.029). The median diameter of the HJB was significantly higher in children with HJB compared to children without HJB on both sides ( P < 0.001). Among newborns, none had HJB. In infants, 11 (30.6%) had HJB; 35 (46.7%) and 37 (50.0%) children aged >12–24 months and >24 months had HJB, respectively. Conclusion A jugular bulb could be identified in all age groups, including newborns. The earliest age of HJB detection was eight months. Overall, 42% of the patients had HJB, which increased by age.

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