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Jugular bulb abnormalities

Jugular bulb abnormalities. DR NGUYEN HUU BAO . A jugular bulb results from dilatation of the upper bulbous portion of the jugular vein. jugular bulb ?. Anatomy. Although their size, location, and configuration vary, most jugular bulbs lie below the hypotympanum.

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Jugular bulb abnormalities

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  1. Jugular bulb abnormalities DR NGUYEN HUU BAO

  2. A jugular bulb results from dilatation of the upper bulbous portion of the jugular vein. jugular bulb ?

  3. Anatomy

  4. Although their size, location, and configuration vary, most jugular bulbs lie below the hypotympanum.

  5.  internal acoustic canal (IAC)

  6. FEMALE , 28 YRS TINNITUS # 7 MONTHS NO COMPLAINT ABOUT HEARING LOSS OR VERTIGO No history of head trauma dehiscence of the jugular bulbCase report

  7. ENDOSCOPY

  8. Ct scan

  9. MRI

  10. Dehiscence of the jugular bulb => SURGERY

  11. Dehiscence of the jugular bulb sigmoid plate is absent

  12. The estimated incidence is ~5% (range 3.5-7%) of the symptomatic population (e.g. those with tinnitus). Retrotympanic vascular mass

  13. Aberrant Internal Carotid Artery Differential diagnosis

  14. Bilateral Aberrant Internal Carotid Arteries

  15. Aneurysms of the internal carotid artery in the carotid canal 

  16. Clinical presentation Patients can present with conductive tinnitus, hearing loss, and vertigo Radiographic features the presence of the sigmoid plate can only be ascertained on CT Turbulent flow within the jugular bulb, the signal on MRI can be confusing

  17. Dehiscence of the jugular bulb=> SURGERY

  18. Review of jugular bulb adnormalities Jugular bulb abnormalities (JBA): 10% -15% of the population. Righ side > Left side High jugulara bulb Jugular bulb diverticulum Dehiscence of the jugular bulb

  19. High jugular bulb Superior aspect of JB extends above floor of IAC with no middle ear connection 5-8% of temporal bone specimens

  20. High jugular bulb

  21. Jugular bulb diverticulum Jugular bulb diverticulum present in 35% of cases with high Jugular Bulb

  22. Jugular bulb diverticulum

  23. Jugular bulb diverticulum

  24. JBA leads to inner-ear erosion in 1.5% to 2.8% of cases The erosions are related to HJB in almost all cases and are also associated with JBD in more than 50% of cases The range of symptomatic forms of JBA is unclear, but it could be involved in ~50% of cases when it is associated with inner-ear erosion

  25. Symptoms include tinnitus and/or hearing loss, and/or vertigo. Intensity of symptoms is variable, but vertigo can be very disabling and may need surgical treatments, for example, jugular bulb lowering or posterior semicircular canal plugging.

  26. Surgical techniques => reducing tinnitus, hearing loss, and vertigo, but require careful surgery to avoid damaging the jugular bulb wall, the inner ear, or the facial nerve Major complications have occurred, such as hearing loss or major bleeds. New treatment for vertigo caused by JBA using an endovascular technique. This technique allows complete removal of symptoms and no complications

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