Temporal bone venous anomaly of surgical significance

Abstract

Variability in the size of the dural sinuses and jugular bulb is not uncommon and usually manifests as a high jugular bulb encroaching upon the floor of the middle ear. A rarer entity is the superior and medial extension of the jugular bulb into the bone of the posterior wall of the internal auditory meatus. We report a case where this anomaly was encountered during acoustic neuroma surgery making exposure of the fundus of the internal auditory meatus technically impossible. The possibility of a communication with the superior petrosal sinus is discussed.

Jugular Bulb Diverticula: Clinical and Radiologic Aspects

“…In the English-language literature, 21 cases with JD exist at this time. [2][3][4][5][6][7][8][9] However, the rarity is questionable. This retrospective study presents 17 new cases identified through the records of 1474 patients with otologic problems and HRCT evaluations.…”

Jugular Bulb Diverticula

“…Moreover, the most suitable strategy can be adopted when other concomitant pathologies have to be faced, such as the presence of an acoustic neurinoma. In this case, in fact, high bulb can create serious difficulties in the preparation of the surgical approach [23],…”

The high jugular bulb in ear surgery: three case reports and a review of the literature

“…Moloy and Brackmann (1986) noted that the jugular bulb can interfere with exposure of the internal auditory canal and described their techniques for managing bleeding from the bulb in such surgery. Suboccipital approaches for acoustic neuroma have also been hindered by a high jugular bulb: Shotton et al (1989) found a superior and medial jugular bulb passing into the bone of the posterior wall of the internal auditory canal, precluding exposure of the fundus. Kennedy et al (1986) described a high jugular bulb posterior to the mid portion of the internal auditory canal.…”