Surgical treatment of the high jugular bulb by compressing sinus sigmoideus: two cases

Eur Arch Otorhinolaryngol. 2008 Aug;265(8):987-91. doi: 10.1007/s00405-007-0545-0. Epub 2007 Nov 29.

Abstract

If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no flow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and different treatment perspectives accompanied by literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Cellulose, Oxidized / therapeutic use
  • Child
  • Cranial Sinuses / surgery*
  • Drug Combinations
  • Female
  • Hemostasis, Surgical
  • Hemostatics / therapeutic use
  • Humans
  • Jugular Veins / abnormalities*
  • Jugular Veins / surgery*
  • Magnetic Resonance Imaging
  • Mastoid / surgery
  • Otologic Surgical Procedures / methods*
  • Palmitates / therapeutic use
  • Temporal Bone / pathology
  • Tomography, X-Ray Computed
  • Tympanic Membrane / surgery
  • Waxes / therapeutic use

Substances

  • Cellulose, Oxidized
  • Drug Combinations
  • Hemostatics
  • Palmitates
  • Waxes
  • bone wax
  • Surgicel