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1 results

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

  • M Ball, M Elloy, R Vaidhyanath, H Pau
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 7 / July 2010
    Published online by Cambridge University Press:
    22 December 2009, pp. 790-792
    Print publication:
    July 2010
  • 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.