J Neurol Surg B Skull Base 2015; 76(06): 471-474
DOI: 10.1055/s-0035-1555747
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Prevalence of High-Riding Jugular Bulb in Patients with Suspected Endolymphatic Hydrops

Christopher D. Brook
1   Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, United States
,
Karen Buch
2   Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, United States
,
Matthew Kaufmann
3   Boston University School of Medicine, Department of Medical Sciences and Education, Boston, Massachusetts, United States
,
Osamu Sakai
2   Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, United States
,
Anand K. Devaiah
1   Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

03 March 2015

13 April 2015

Publication Date:
15 June 2015 (online)

Abstract

Background To determine the prevalence of a high-riding jugular bulb (HRJB) in the endolymphatic hydrops population.

Methods This was a retrospective chart and radiology review of patients seen at a tertiary care medical center. Patients were identified using the International Classification of Diseases, 9th edition, code 386.xx (Meniere disease–unspecified), and were required to have undergone an imaging study that included views of the jugular bulb that were available for review. A radiologist then evaluated all of the imaging studies for evidence of HRJB or inner ear dehiscence with a jugular bulb abnormality.

Results The prevalence of a HRJB in all endolymphatic hydrops patients was 9.0% (7 of 78), and it was 4.5% (7 of 156) in all ears. The prevalence of HRJB ipsilateral to an ear with endolymphatic hydrops was 4.6% (4 of 88 ears); it was 4.4% (3 of 68 ears) in ears without endolymphatic hydrops. The incidence of inner ear dehiscence with a HRJB was 1.3% (1 of 78). Electrocochleography results were not correlated with jugular bulb volume.

Discussion The results of this study indicate that a small subset of patients treated for endolymphatic hydrops patients have a HRJB. Overall, these results suggest that HRJB does not play a major role in endolymphatic hydrops, although it may play a role in a few isolated patients.

 
  • References

  • 1 Okudera T, Huang YP, Ohta T , et al. Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol 1994; 15 (10) 1871-1883
  • 2 Friedmann DR, Eubig J, McGill M, Babb JS, Pramanik BK, Lalwani AK. Development of the jugular bulb: a radiologic study. Otol Neurotol 2011; 32 (8) 1389-1395
  • 3 Wadin K, Thomander L, Wilbrand H. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation. Acta Radiol Diagn (Stockh) 1986; 27 (6) 629-636
  • 4 Rauch SD, Xu WZ, Nadol Jr JB. High jugular bulb: implications for posterior fossa neurotologic and cranial base surgery. Ann Otol Rhinol Laryngol 1993; 102 (2) 100-107
  • 5 Hourani R, Carey J, Yousem DM. Dehiscence of the jugular bulb and vestibular aqueduct: findings on 200 consecutive temporal bone computed tomography scans. J Comput Assist Tomogr 2005; 29 (5) 657-662
  • 6 Friedmann DR, Le BT, Pramanik BK, Lalwani AK. Clinical spectrum of patients with erosion of the inner ear by jugular bulb abnormalities. Laryngoscope 2010; 120 (2) 365-372
  • 7 Gopen Q, Zhou G, Poe D, Kenna M, Jones D. Posterior semicircular canal dehiscence: first reported case series. Otol Neurotol 2010; 31 (2) 339-344
  • 8 Friedmann DR, Eubig J, Winata LS, Pramanik BK, Merchant SN, Lalwani AK. Prevalence of jugular bulb abnormalities and resultant inner ear dehiscence: a histopathologic and radiologic study. Otolaryngol Head Neck Surg 2012; 147 (4) 750-756
  • 9 Wadin K, Wilbrand H. The jugular bulb diverticulum. A radioanatomic investigation. Acta Radiol Diagn (Stockh) 1986; 27 (4) 395-401
  • 10 Atilla S, Akpek S, Uslu S, Ilgit ET, Işik S. Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol 1995; 20 (1) 52-56
  • 11 Bilgen C, Kirazli T, Ogut F, Totan S. Jugular bulb diverticula: clinical and radiologic aspects. Otolaryngol Head Neck Surg 2003; 128 (3) 382-386
  • 12 Couloigner V, Grayeli AB, Bouccara D, Julien N, Sterkers O. Surgical treatment of the high jugular bulb in patients with Ménière's disease and pulsatile tinnitus. Eur Arch Otorhinolaryngol 1999; 256 (5) 224-229
  • 13 Redfern RE, Brown M, Benson AG. High jugular bulb in a cohort of patients with definite Ménière's disease. J Laryngol Otol 2014; 128 (9) 759-764
  • 14 Schmerber S, Lefournier V, Lavieille JP, Boubagra K. Endolymphatic duct obstruction related to a jugular bulb diverticulum: high resolution CT and MR imaging findings. Clin Radiol 2002; 57 (5) 424-428
  • 15 Park JJ, Shen A, Keil S, Kuhl C, Westhofen M. Jugular bulb abnormalities in patients with Meniere's disease using high-resolution computed tomography. Eur Arch Otorhinolaryngol 2014; ; March 20 (Epub ahead of print)
  • 16 Hollinshead WH. Anatomy for Surgeons: The Head and Neck. Hagerstown, MD: Harper & Row; 1982
  • 17 Schuknecht HR. Pathology of the Ear. 2nd ed. Philadelphia, PA: Lea and Febiger; 1993
  • 18 Levine SB, Snow Jr JB. Pulsatile tinnitus. Laryngoscope 1987; 97 (4) 401-406
  • 19 American Academy of Otolaryngology-Head and NeckFoundation. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg 1995; 113 (3) 181-185
  • 20 Friedmann DR, Eubig J, Winata LS, Pramanik BK, Merchant SN, Lalwani AK. A clinical and histopathologic study of jugular bulb abnormalities. Arch Otolaryngol Head Neck Surg 2012; 138 (1) 66-71
  • 21 Margolis RH, Rieks D, Fournier EM, Levine SE. Tympanic electrocochleography for diagnosis of Menière's disease. Arch Otolaryngol Head Neck Surg 1995; 121 (1) 44-55
  • 22 Adams ME, Heidenreich KD, Kileny PR. Audiovestibular testing in patients with Meniere's disease. Otolaryngol Clin North Am 2010; 43 (5) 995-1009