Objective: Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo
can be very disabling and may need skull base surgical treatments with risk of hearing
loss, major bleeding or facial palsy. Hence, we have developed a new treatment for
vertigo caused by jugular bulb anomalies, using an endovascular technique. Patients: Three patients presented with severe vertigos mostly induced by high venous pressure.
One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone
CT scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence
and compression of the vestibular aqueduct in all cases. Intervention: We plugged
the upper part of the bulb with coils, and we used a stent to maintain the coils and
preserving the venous permeability. Results: After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing
return to work. The 3-montharteriographs showed good permeability of the sigmoid sinus
and jugular bulb through the stent, with complete obstruction of the upper part of
the bulb in all cases. Conclusion: Disabling vertigo induced by jugular bulb abnormalities can be effectively treated
by an endovascular technique. This technique is minimally invasive with a probable
greater benefit/risk ratio compare with surgery.
