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High jugular bulb in a cohort of patients with definite Ménière's disease

Published online by Cambridge University Press:  27 August 2014

R E Redfern
Affiliation:
Research Department, Toledo Hospital, Ohio, USA
M Brown
Affiliation:
Research Department, Toledo Hospital, Ohio, USA
A G Benson*
Affiliation:
Ohio Hearing and Balance Institute, Toledo Ear Nose and Throat, St. Luke's Hospital, Maumee, Ohio, USA
*
Address for correspondence: Dr A Benson, Ohio Hearing and Balance Institute, Toledo Ear Nose and Throat, St. Luke's Hospital, 6005 Monclova Road, Maumee, OH 43537, USA Fax: +1 419 972–0016 E-mail: [email protected]

Abstract

Objective:

To determine the incidence of high jugular bulb in a group of patients with definite Ménière's disease, and to investigate whether the position or size of the jugular bulb is significantly different in the affected ear than in the unaffected ear.

Methods:

Retrospective review of patient charts, audiograms, and computed tomography scans to determine the position and size of the jugular bulb in the affected and contralateral ears, as well as other abnormalities.

Results:

High jugular bulb was found in 57.1 per cent of affected ears. Encroachment of the cochlear and vestibular aqueducts was apparent in 39.3 per cent and 35.7 per cent, respectively, of affected ears. Diverticulum and dehiscence were observed in 28.6 per cent of affected ears. High jugular bulb was significantly associated with encroachment of the cochlear aqueduct (p = 0.003).

Conclusion:

The mediolateral and anteroposterior position of the jugular bulb determines encroachment of the surrounding structures. An abnormal position is postulated to contribute to the development of Ménière's disease.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Friedmann, 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;147:750–6CrossRefGoogle ScholarPubMed
2Friedmann, 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;138:6671CrossRefGoogle ScholarPubMed
3Friedmann, DR, Eubig, J, McGill, M, Babb, JS, Pramanik, BK, Lalwani, AK. Development of the jugular bulb: a radiologic study. Otol Neurotol 2011;32:1389–95Google Scholar
4Fujimoto, C, Ito, K, Ishimoto, S, Iwasaki, S. Large jugular bulb diverticulum invading the internal auditory canal. Ann Otol Rhinol Laryngol 2007;116:631–6Google Scholar
5Vachata, P, Petrovicky, P, Sames, M. An anatomical and radiological study of the high jugular bulb on high-resolution CT scans and alcohol-fixed skulls of adults. J Clin Neurosci 2010;17:473–8Google Scholar
6Bilgen, C, Kirazli, T, Ogut, F, Totan, S. Jugular bulb diverticula: clinical and radiologic aspects. Otolaryngol Head Neck Surg 2003;128:382–6Google Scholar
7Hourani, 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;29:657–62Google Scholar
8Wadin, 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;27:629–36CrossRefGoogle ScholarPubMed
9Woo, CK, Wie, CE, Park, SH, Kong, SK, Lee, IW, Goh, EK. Radiologic analysis of high jugular bulb by computed tomography. Otol Neurotol 2012;33:1283–7CrossRefGoogle ScholarPubMed
10Kuhn, MA, Friedmann, DR, Winata, LS, Eubig, J, Pramanik, BK, Kveton, J et al. Large jugular bulb abnormalities involving the middle ear. Otol Neurotol 2012;33:1201–6CrossRefGoogle ScholarPubMed
11Couloigner, V, Grayeli, AB, Bouccara, D, Julien, N, Sterkers, O. Surgical treatment of the high jugular bulb in patients with Meniere's disease and pulsatile tinnitus. Eur Arch Otorhinolaryngol 1999;256:224–9Google Scholar
12Schmerber, 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;57:424–8CrossRefGoogle ScholarPubMed
13Sterkers, O, Bozorg Grayeli, A, Julien, N, Bouccara, D, Rihane, S, Chaigne, P. Jugular bulb diverticulum mimicking Meniere's disease. Surgical treatment [in French]. Ann Otolaryngol Chir Cervicofac 1993;110:363–71Google Scholar
14Manzari, L. Vestibular signs and symptoms of volumetric abnormalities of the vestibular aqueduct. J Laryngol Otol 2008;122:557–63CrossRefGoogle ScholarPubMed
15Proctor, CA, Proctor, TB, Proctor, B. Etiology and treatment of fluid retention (hydrops) in Meniere's syndrome. Ear Nose Throat J 1992;71:631–5Google Scholar
16Bohmer, A, Dillier, N. Experimental endolymphatic hydrops: are cochlear and vestibular symptoms caused by increased endolymphatic pressure? Ann Otol Rhinol Laryngol 1990;99:470–6CrossRefGoogle ScholarPubMed
17American Academy of Otolaryngology-Head and Neck Foundation. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. Otolaryngol Head Neck Surg 1995;113:181–5CrossRefGoogle Scholar
18Friedmann, DR, Le, BT, Pramanik, BK, Lalwani, AK. Clinical spectrum of patients with erosion of the inner ear by jugular bulb abnormalities. Laryngoscope 2010;120:365–72CrossRefGoogle ScholarPubMed
19Low, WK, Fenton, JE, Fagan, PA, Gibson, WP. The influence of race on the position of the jugular bulb. J Laryngol Otol 1995;109:610–13Google Scholar
20R Development Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria; Vienna, Austria: the R Foundation for Statistical Computing, 2012.Google Scholar
21Yetiser, S, Kertmen, M, Yildirim, A. An analysis of correlation between the unusual location of the jugular bulb and audiovestibular symptoms. Auris Nasus Larynx 2004;31:369–77Google Scholar
22Kawano, H, Tono, T, Schachern, PA, Paparella, MM, Komune, S. Petrous high jugular bulb: a histological study. Am J Otolaryngol 2000;21:161–8Google Scholar
23Gianoli, GJ, Larouere, MJ, Kartush, JM, Wayman, J. Sac-vein decompression for intractable Meniere's disease: two-year treatment results. Otolaryngol Head Neck Surg 1998;118:22–9Google Scholar