Abstract
OBJECTIVE: Jugular bulb abnormalities (JBA), such as jugular bulb diverticula (JBD) or large jugular bulbs, rarely present in the middle ear. We review a large series of temporal bone histopathologic specimens to determine their prevalence and present a series of cases of JB abnormalities involving the middle ear (JBME) that shed light on the probable mechanism for their development. PATIENTS: 1,579 unique temporal bone specimens and individuals with radiographically-diagnosed JBME. INTERVENTION: Histopathologic and clinical review of temporal bone specimens and patient presentations, radiographic findings, treatments and outcomes. MAIN OUTCOME MEASURE: Shared characteristics of JBME. RESULTS: There were 17 cases of JBME in 1,579 temporal bone (1.1%), of which, 15 involved the inferior mesotympanum below the level of the round window membrane (RWM), whereas 2 encroached upon the RWM or ossicles. In addition, 4 clinical cases of large JBME extending above RWM were encountered; these occurred in both sexes with ages spanning from young to old (7-66 yr). They presented with conductive hearing loss (n = 3), ear canal mass (n = 1), and intraoperative bleeding (n = 1). Radiologically, they had multiple diverticula of the JB on the side with JBME, with 1 patient demonstrating growth on serial imaging studies. All patients who underwent additional imaging had marked hypoplastic contralateral transverse sinus. CONCLUSION: JBME abnormalities are rare, present across age groups, and may demonstrate serial growth over time. They are usually associated with multiple other diverticula within the same JB. Our clinical series suggests that JBME's development and uniquely aggressive behavior results from contralateral transverse sinus outflow obstruction.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1201-1206 |
| Number of pages | 6 |
| Journal | Otology and Neurotology |
| Volume | 33 |
| Issue number | 7 |
| DOIs | |
| State | Published - Sep 1 2012 |
| Externally published | Yes |
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Keywords
- High-riding jugular bulb
- Jugular bulb
- Jugular bulb diverticulum
ASJC Scopus subject areas
- Otorhinolaryngology
- Clinical Neurology
- Sensory Systems
- Medicine(all)
Cite this
Large jugular bulb abnormalities involving the middle ear. / Kuhn, Maggie; Friedmann, David R.; Winata, Leon S.; Eubig, Jan; Pramanik, Bidyut K.; Kveton, John; Kohan, Darius; Merchant, Saumil N.; Lalwani, Anil K.
In: Otology and Neurotology, Vol. 33, No. 7, 01.09.2012, p. 1201-1206.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Large jugular bulb abnormalities involving the middle ear
AU - Kuhn, Maggie
AU - Friedmann, David R.
AU - Winata, Leon S.
AU - Eubig, Jan
AU - Pramanik, Bidyut K.
AU - Kveton, John
AU - Kohan, Darius
AU - Merchant, Saumil N.
AU - Lalwani, Anil K.
PY - 2012/9/1
Y1 - 2012/9/1
N2 - OBJECTIVE: Jugular bulb abnormalities (JBA), such as jugular bulb diverticula (JBD) or large jugular bulbs, rarely present in the middle ear. We review a large series of temporal bone histopathologic specimens to determine their prevalence and present a series of cases of JB abnormalities involving the middle ear (JBME) that shed light on the probable mechanism for their development. PATIENTS: 1,579 unique temporal bone specimens and individuals with radiographically-diagnosed JBME. INTERVENTION: Histopathologic and clinical review of temporal bone specimens and patient presentations, radiographic findings, treatments and outcomes. MAIN OUTCOME MEASURE: Shared characteristics of JBME. RESULTS: There were 17 cases of JBME in 1,579 temporal bone (1.1%), of which, 15 involved the inferior mesotympanum below the level of the round window membrane (RWM), whereas 2 encroached upon the RWM or ossicles. In addition, 4 clinical cases of large JBME extending above RWM were encountered; these occurred in both sexes with ages spanning from young to old (7-66 yr). They presented with conductive hearing loss (n = 3), ear canal mass (n = 1), and intraoperative bleeding (n = 1). Radiologically, they had multiple diverticula of the JB on the side with JBME, with 1 patient demonstrating growth on serial imaging studies. All patients who underwent additional imaging had marked hypoplastic contralateral transverse sinus. CONCLUSION: JBME abnormalities are rare, present across age groups, and may demonstrate serial growth over time. They are usually associated with multiple other diverticula within the same JB. Our clinical series suggests that JBME's development and uniquely aggressive behavior results from contralateral transverse sinus outflow obstruction.
AB - OBJECTIVE: Jugular bulb abnormalities (JBA), such as jugular bulb diverticula (JBD) or large jugular bulbs, rarely present in the middle ear. We review a large series of temporal bone histopathologic specimens to determine their prevalence and present a series of cases of JB abnormalities involving the middle ear (JBME) that shed light on the probable mechanism for their development. PATIENTS: 1,579 unique temporal bone specimens and individuals with radiographically-diagnosed JBME. INTERVENTION: Histopathologic and clinical review of temporal bone specimens and patient presentations, radiographic findings, treatments and outcomes. MAIN OUTCOME MEASURE: Shared characteristics of JBME. RESULTS: There were 17 cases of JBME in 1,579 temporal bone (1.1%), of which, 15 involved the inferior mesotympanum below the level of the round window membrane (RWM), whereas 2 encroached upon the RWM or ossicles. In addition, 4 clinical cases of large JBME extending above RWM were encountered; these occurred in both sexes with ages spanning from young to old (7-66 yr). They presented with conductive hearing loss (n = 3), ear canal mass (n = 1), and intraoperative bleeding (n = 1). Radiologically, they had multiple diverticula of the JB on the side with JBME, with 1 patient demonstrating growth on serial imaging studies. All patients who underwent additional imaging had marked hypoplastic contralateral transverse sinus. CONCLUSION: JBME abnormalities are rare, present across age groups, and may demonstrate serial growth over time. They are usually associated with multiple other diverticula within the same JB. Our clinical series suggests that JBME's development and uniquely aggressive behavior results from contralateral transverse sinus outflow obstruction.
KW - High-riding jugular bulb
KW - Jugular bulb
KW - Jugular bulb diverticulum
UR - http://www.scopus.com/inward/record.url?scp=84865582010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84865582010&partnerID=8YFLogxK
U2 - 10.1097/MAO.0b013e31825d97fa
DO - 10.1097/MAO.0b013e31825d97fa
M3 - Article
C2 - 22772004
AN - SCOPUS:84865582010
VL - 33
SP - 1201
EP - 1206
JO - Otology and Neurotology
JF - Otology and Neurotology
SN - 1531-7129
IS - 7
ER -