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

Published online by Cambridge University Press:  22 December 2009

M Ball ,
M Elloy ,
R Vaidhyanath  and
H Pau
M Ball*
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
M Elloy
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
R Vaidhyanath
Affiliation:
Department of Radiology, Leicester Royal Infirmary, UK
H Pau
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
*
Address for correspondence: Miss Mary Ball, Department of Otolaryngology, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK. Fax: 0116 258 6082 E-mail: maryball@doctors.org.uk
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Abstract

Objective:

We report two rare cases of high and dehiscent jugular bulbs protruding into the external ear canal; one case was silent, the other symptomatic.

Method:

The cases are presented and the relevant literature reviewed and discussed.

Results:

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.

Conclusion:

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.

Keywords

Case ReportJugular, DehiscenceRadiology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 7 , July 2010 , pp. 790 - 792
Copyright
Copyright © JLO (1984) Limited 2009

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