Jugular bulb abnormalities and their surgical implications
DOI:
https://doi.org/10.34631/sporl.716Keywords:
jugular bulb, middle ear, diverticulum, bleedingAbstract
Introduction: Jugular bulb abnormalities (JBA) are mostly asymptomatic and present as an incidental finding during surgical exploration. We report four cases of JBA in patients undergoing middle ear surgery.
Cases Reports: A miringotomy was performed in a 7-year-old child with a bluish mass behind the tympanic membrane. CT and MR revealed a high-riding jugular bulb. The second and third patients underwent exploratory tympanotomy. One case, on raising the tympanomeatal flap, we verified a jugular bulb protruding into the mesotympanum, nearby incudostapedial joint. This finding let us to abort the operation because of a jugular diverticulum. The other consisted in a stapedotomy, whose CT revealed a high-riding jugular bulb accompanied by a medial diverticulum. The last patient underwent mastoidectomy for cholesteatoma. While entering the middle ear, a high jugular bulb bleeding occured. It was controlled by applying Surgicel®.
Conclusion: JBA diagnosis becomes challenging before operation, leading to an inadvertent entry into the venous system.
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