Large jugular bulb abnormalities involving the middle ear

Maggie Kuhn, David R. Friedmann, Leon S. Winata, Jan Eubig, Bidyut K. Pramanik, John Kveton, Darius Kohan, Saumil N. Merchant, Anil K. Lalwani

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)1201-1206
Number of pages6
JournalOtology and Neurotology
Volume33
Issue number7
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Fingerprint

Temporal Bone
Middle Ear
Diverticulum
Neck
Transverse Sinuses
Membranes
Conductive Hearing Loss
Ear Canal
Growth
Age Groups
Hemorrhage

Keywords

  • High-riding jugular bulb
  • Jugular bulb
  • Jugular bulb diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

Kuhn, M., Friedmann, D. R., Winata, L. S., Eubig, J., Pramanik, B. K., Kveton, J., ... Lalwani, A. K. (2012). Large jugular bulb abnormalities involving the middle ear. Otology and Neurotology, 33(7), 1201-1206. https://doi.org/10.1097/MAO.0b013e31825d97fa

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 journalArticle

Kuhn, M, Friedmann, DR, Winata, LS, Eubig, J, Pramanik, BK, Kveton, J, Kohan, D, Merchant, SN & Lalwani, AK 2012, 'Large jugular bulb abnormalities involving the middle ear', Otology and Neurotology, vol. 33, no. 7, pp. 1201-1206. https://doi.org/10.1097/MAO.0b013e31825d97fa
Kuhn M, Friedmann DR, Winata LS, Eubig J, Pramanik BK, Kveton J et al. Large jugular bulb abnormalities involving the middle ear. Otology and Neurotology. 2012 Sep 1;33(7):1201-1206. https://doi.org/10.1097/MAO.0b013e31825d97fa
Kuhn, Maggie ; Friedmann, David R. ; Winata, Leon S. ; Eubig, Jan ; Pramanik, Bidyut K. ; Kveton, John ; Kohan, Darius ; Merchant, Saumil N. ; Lalwani, Anil K. / Large jugular bulb abnormalities involving the middle ear. In: Otology and Neurotology. 2012 ; Vol. 33, No. 7. pp. 1201-1206.
@article{6d52b6998d664b868f816f6fb596bf59,
title = "Large jugular bulb abnormalities involving the middle ear",
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.",
keywords = "High-riding jugular bulb, Jugular bulb, Jugular bulb diverticulum",
author = "Maggie Kuhn and Friedmann, {David R.} and Winata, {Leon S.} and Jan Eubig and Pramanik, {Bidyut K.} and John Kveton and Darius Kohan and Merchant, {Saumil N.} and Lalwani, {Anil K.}",
year = "2012",
month = "9",
day = "1",
doi = "10.1097/MAO.0b013e31825d97fa",
language = "English (US)",
volume = "33",
pages = "1201--1206",
journal = "Otology and Neurotology",
issn = "1531-7129",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

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 -