Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal

We report two rare cases of high and dehiscent jugular bulbs protruding into the external ear canal; one case was silent, the other symptomatic. The cases are presented and the relevant literature reviewed and discussed. A 52-year-old woman underwent mastoid exploration for suspected cholesteatoma....

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Bibliographic Details
Published in:Journal of laryngology and otology 2010-07, Vol.124 (7), p.790-792
Main Authors: Ball, M, Elloy, M, Vaidhyanath, R, Pau, H
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Case Report
Dehiscence
Ear Canal - diagnostic imaging
Ear Canal - surgery
Ears & hearing
Female
Hemorrhage - etiology
Humans
Jugular
Jugular Veins - abnormalities
Jugular Veins - diagnostic imaging
Male
Medical imaging
Medical sciences
Middle Aged
Otorhinolaryngology. Stomatology
Radiology
Sinuses
Tomography, X-Ray Computed
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Summary:We report two rare cases of high and dehiscent jugular bulbs protruding into the external ear canal; one case was silent, the other symptomatic. The cases are presented and the relevant literature reviewed and discussed. A 52-year-old woman underwent mastoid exploration for suspected cholesteatoma. On raising the tympanomeatal flap, while still lateral to the annulus, brisk venous bleeding occurred from a high, dehiscent jugular bulb in the external ear canal. The second patient, a 42-year-old man, underwent imaging for suspected glomus tumour. A high, dehiscent jugular bulb was found protruding into the external ear canal and hypotympanum. High jugular bulbs in the middle ear have been reported many times. To our knowledge, there has only been one previous report of a high jugular bulb in the external ear. These cases illustrate the importance of full, accurate assessment of high resolution computed tomography images, and of appropriate, immediate management of bleeding.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215109992349