A high-riding jugular bulb is a common vascular anomaly, found in
2.4-7% of temporal bones
. About 5 fold higher prevalence of high-jugular bulb is reported in patients with ear related symptoms — Sayit et al reported 22% in 730 patients presenting to otolaryngology (2016).
How do you treat a high jugular bulb?
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.
Can a high riding jugular bulb be fixed?
Tinnitus and hearing loss can occur in patients with a high-riding abnormal jugular bulb.
Jugular vein ligation in selected patients can cure tinnitus and reverse hearing loss
.
How serious is a jugular bulb?
Conclusions
Jugular bulb abnormalities can erode into the vestibular aqueduct, facial nerve, and the posterior semicircular canal
. While symptoms may include pulsatile tinnitus, vertigo, or conductive hearing loss, in contrast to earlier reports, half of the patients were asymptomatic.
What effect does high jugular bulb in ear?
Previous studies on high jugular bulb revealed
worse hearing thresholds and progressive hearing
in the affected ears of patients with bilateral hearing loss (Tsunoda, 2000; Sasindran et al., 2014).
Can a high riding jugular bulb cause dizziness?
A HRJB has been implicated as the cause of symptoms including dizziness
, conductive hearing loss, sensorineural hearing loss, vertigo, and pulsatile tinnitus.
Can a high riding jugular bulb cause pulsatile tinnitus?
It is believed that venous sinus stenosis and a high-riding jugular bulb with diverticulum are associated with turbulent blood flow near the middle ear, and therefore are responsible for objective pulsatile tinnitus
.
What is jugular bulb dehiscence?
A dehiscent jugular bulb is defined as
a normal venous variant with superior and lateral extension of the jugular bulb into the middle-ear cavity through a dehiscent sigmoid plate
[1]. Despite its rare frequency, dehiscent jugular bulb is one of the common cause of pulsatile tinnitus.
What is jugular bulb diverticulum?
The jugular bulb diverticulum (JBD) is
an irregular outpouching of the jugular bulb that may extend to the superior surface of the petrous bone, middle ear cavity, endolymphatic duct or vestibular aqueduct
.1-3) Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size.
What is the most common cause of conductive hearing loss?
According to Rothholtz, the most common cause of conductive hearing loss is
a buildup of earwax that muffles sound
. Rothholtz adds that some other types of conductive hearing loss include: Otosclerosis: This causes bone from the cochlea to grow onto the stapes bone in the middle ear, making it more difficult to hear.
What does JVD mean?
When the jugular vein is visible, it’s known as
jugular vein distention
(JVD). Internal and external jugular veins run along the right and left sides of your neck. They bring blood from your head to the superior vena cava, which is the largest vein in the upper body.
What is pulsatile tinnitus?
What Is Pulsatile Tinnitus? People with pulsatile tinnitus
often hear rhythmic thumping, whooshing or throbbing in one or both ears
. Some patients report the sounds as annoying. But for others, the sounds are intense and debilitating, making it difficult to concentrate or sleep.
Can pulsatile tinnitus make you dizzy?
The main symptom of pulsatile tinnitus is hearing a sound in your ears that seems to match your heartbeat or pulse. You may even be able to take your pulse while you’re hearing the sound in your ears.
You may also notice heart palpitations or feelings of lightheadedness
.
What is a sigmoid plate?
The sigmoid plate is variously described as
the plate of bone between the jugular bulb and the middle ear cavity
(as shown in first image) or more generally as the thin bone separating the sigmoid sinus from adjacent structures (especially mastoid air cells).
Can a high riding jugular bulb cause headache?
Headache and facial nerve palsy can be caused by high mega jugular bulb
. Surgery is indicated in such symptomatic cases and leads to relief of signs and symptoms of disease. High mega jugular bulb is a vascular abnormality of the internal jugular vein (IJV) at the jugular foramen.
What is jugular vein ligation?
Jugular vein ligation in selected patients
can cure tinnitus and reverse hearing loss
. A 39-year-old woman reported a 4-year history of right-sided tinnitus of increasing intensity associated with a mild hearing loss.
Where is the jugular foramen?
The jugular foramen is situated
in an oblique plane along the skull base
. Its boundaries include the petrous temporal bone anterolaterally and the jugular process of the occipital condyle posteromedially. The jugular foramen is usually larger on the right than on the left.
Can an ear infection cause a cyst?
Repeated infections and/or and a tear or retraction of the eardrum can cause the skin to toughen and form an expanding sac
. Cholesteatomas often devolop as cysts or pouches that shed layers of old skin, which build up inside the middle ear.
What is hydrops in adults?
Ear Hydrops is
a disorder of the vestibular system in the inner ear
. It is the result of abnormal fluctuations in the endolymph fluid that fills the hearing and balance structures of the inner ear.
What is keratosis Obturan?
Keratosis obturans (KO) is
the buildup of keratin in the ear canal
. Keratin is a protein released by skin cells that form the hair, nails, and protective barrier on the skin.
What is vestibular aqueduct?
The vestibular aqueduct is
the bony canal that travels away from the vestibule and into the temporal bone
. The aqueduct contains the membranous cochlear duct and terminates in the endolymphatic sac. When the aqueduct is enlarged, the endolymphatic sac and duct tend to enlarge and fill the space.
Can jugular vein cause tinnitus?
Augmented or turbulent flow within the transverse-sigmoid-jugular venous system is one of the more common causes of pulsatile tinnitus
. Characteristically, the pulsation can be temporarily muted or even abolished by relatively gentle compression of the ipsilateral neck.
Can cervical stenosis cause pulsatile tinnitus?
The narrowing, or stenosis, disrupts the flow of blood and can lead to the whooshing sound or other noises of pulsatile tinnitus
. Pulsatile tinnitus can be caused by problems in the arteries or veins of the head, neck, or both.
What is sigmoid sinus dehiscence?
Sigmoid sinus dehiscence, also known as sigmoid plate dehiscence, refers to
a defect in the sigmoid plate such that the sigmoid sinus is not separated by bone from the air in the mastoid air cells
.
