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

Abstract

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.