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Validation of a novel jugular bulb classification in otology and lateral skull base surgery: a neuro-otologist’s perspective

Published online by Cambridge University Press:  18 July 2025

Nidhin Das K.
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Amit Keshri
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Kanika Arora
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Nazrin Hameed
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Mohd Aqib
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Kalyana Sundaram Chithambaram
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Mohit Sinha Neeraj Jain
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India Department of Radiodiagnosis and Interventional Radiology, SGPGIMS, Lucknow, UP, India
Vivek Singh
Affiliation:
Department of Radiodiagnosis and Interventional Radiology, SGPGIMS, Lucknow, UP, India
Kuntal Kanti Das
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Kamlesh Bhaisora
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Arun Kumar Srivastava
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Anant Mehrotra
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Awadesh Kumar Jaiswal
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
Ravi Sankar Manogaran*
Affiliation:
Department of Neurosurgery, SGPGIMS, Lucknow, UP, India
*
Corresponding author: Ravi Sankar Manogaran; Email: drravisankarpgi@gmail.com

Abstract

Objectives

The study aim is to validate the utility and implications of the Manjila jugular bulb classification.

Methods

A retrospective study of 182 patients who underwent lateral skull base or otologic surgery was conducted. Pre-operative temporal bone computed tomography and magnetic resonance imagery scans were reviewed, and the classification was independently applied by a neuroradiologist and neuro-otologist. Concordance among imaging, intra-operative findings, complications, and functional outcomes was assessed.

Results

Substantial agreement was found between imaging and intra-operative findings (Cohen’s kappa = 0.78). High-riding jugular bulbs were present in 13.7 per cent of cases, with complications such as venous bleeding (5.5 per cent) and cranial nerve palsy (2.7 per cent). Surgical approaches were altered in 25 per cent of cases. Functional outcomes, including hearing and facial nerve preservation, were not correlated with jugular bulb grades.

Conclusion

The classification demonstrated strong concordance with intra-operative findings, emphasising the importance of pre-operative identification for tailored surgical planning.

Information

Type
Main Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Ravi Sankar Manogaran takes responsibility for the integrity of the content of the paper

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