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Head and Neck
Diagnosis
Skull Base Lesions
Jugular Foramen
Dehiscent Jugular Bulb
Dehiscent Jugular Bulb
H. Ric Harnsberger, MD; Sara Strauss, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Dehiscent jugular bulb (DJB)

            • Synonyms

              • Exposed jugular bulb (JB), lateral JB diverticulum

            • Definitions

              • Normal venous variant with superior & lateral extension of JB into middle ear (ME) through dehiscent sigmoid plate

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Hu J et al: Value of CT and three-dimensional reconstruction revealing specific radiological signs for screening causative high jugular bulb in patients with Meniere's disease. BMC Med Imaging. 20(1):103, 2020
                                        2. Lee SY et al: Jugular bulb resurfacing with bone cement for patients with high dehiscent jugular bulb and ipsilateral pulsatile tinnitus. Otol Neurotol. 40(2):192-9, 2019
                                        3. Atmaca S et al: High and dehiscent jugular bulb: clear and present danger during middle ear surgery. Surg Radiol Anat. 36(4):369-74, 2014
                                        4. Ball M et al: Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal. J Laryngol Otol. 124(7):790-2, 2010
                                        5. El-Begermy MA et al: A novel surgical technique for management of tinnitus due to high dehiscent jugular bulb. Otolaryngol Head Neck Surg. 142(4):576-81, 2010
                                        6. Huang BR et al: Dehiscent high jugular bulb: a pitfall in middle ear surgery. Otol Neurotol. 27(7):923-7, 2006
                                        7. Hourani R et al: Dehiscence of the jugular bulb and vestibular aqueduct: findings on 200 consecutive temporal bone computed tomography scans. J Comput Assist Tomogr. 29(5):657-62, 2005
                                        8. Tsunoda A: Sensorineural hearing loss caused by a high jugular bulb. J Laryngol Otol. 114(11):867-9, 2000
                                        9. Weissman JL et al: Imaging of tinnitus: a review. Radiology. 216(2):342-9, 2000
                                        10. Couloigner V et al: Surgical treatment of the high jugular bulb in patients with Meniere's disease and pulsatile tinnitus. Eur Arch Otorhinolaryngol. 256(5):224-9, 1999
                                        11. Saito T et al: High jugular bulb adhering to the eardrum. Ann Otol Rhinol Laryngol. 108(6):620-2, 1999
                                        12. Tekdemir I et al: The jugular foramen: a comparative radioanatomic study. Surg Neurol. 50(6):557-62, 1998
                                        13. Caldemeyer KS et al: The jugular foramen: a review of anatomy, masses, and imaging characteristics. Radiographics. 17(5):1123-39, 1997
                                        14. Weiss RL et al: High jugular bulb and conductive hearing loss. Laryngoscope. 107(3):321-7, 1997
                                        15. Atilla S et al: Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol. 20(1):52-6, 1995
                                        16. Tomura N et al: Normal variations of the temporal bone on high-resolution CT: their incidence and clinical significance. Clin Radiol. 50(3):144-8, 1995
                                        17. Dietz RR et al: MR imaging and MR angiography in the evaluation of pulsatile tinnitus. AJNR Am J Neuroradiol. 15(5):879-89, 1994
                                        18. Shotton JC et al: Temporal bone venous anomaly of surgical significance. J Laryngol Otol. 103(1):101-6, 1989
                                        19. Mueller DP et al: Enlarged jugular foramen. Ann Otol Rhinol Laryngol. 97(3 Pt 1):326-7, 1988
                                        20. Smith B et al: Dehiscent jugular bulb. Ann Otol Rhinol Laryngol. 96(2 Pt 1):232-3, 1987
                                        21. Daniels DL et al: Jugular foramen: anatomic and computed tomographic study. AJR Am J Roentgenol. 142(1):153-8, 1984
                                        22. Lo WW et al: High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology. 150(3):743-7, 1984
                                        23. Ongre A: The jugular bulb once more. AJR Am J Roentgenol. 135(5):1117, 1980
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Dehiscent jugular bulb (DJB)

                                                  • Synonyms

                                                    • Exposed jugular bulb (JB), lateral JB diverticulum

                                                  • Definitions

                                                    • Normal venous variant with superior & lateral extension of JB into middle ear (ME) through dehiscent sigmoid plate

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Angiographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Hu J et al: Value of CT and three-dimensional reconstruction revealing specific radiological signs for screening causative high jugular bulb in patients with Meniere's disease. BMC Med Imaging. 20(1):103, 2020
                                                                              2. Lee SY et al: Jugular bulb resurfacing with bone cement for patients with high dehiscent jugular bulb and ipsilateral pulsatile tinnitus. Otol Neurotol. 40(2):192-9, 2019
                                                                              3. Atmaca S et al: High and dehiscent jugular bulb: clear and present danger during middle ear surgery. Surg Radiol Anat. 36(4):369-74, 2014
                                                                              4. Ball M et al: Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal. J Laryngol Otol. 124(7):790-2, 2010
                                                                              5. El-Begermy MA et al: A novel surgical technique for management of tinnitus due to high dehiscent jugular bulb. Otolaryngol Head Neck Surg. 142(4):576-81, 2010
                                                                              6. Huang BR et al: Dehiscent high jugular bulb: a pitfall in middle ear surgery. Otol Neurotol. 27(7):923-7, 2006
                                                                              7. Hourani R et al: Dehiscence of the jugular bulb and vestibular aqueduct: findings on 200 consecutive temporal bone computed tomography scans. J Comput Assist Tomogr. 29(5):657-62, 2005
                                                                              8. Tsunoda A: Sensorineural hearing loss caused by a high jugular bulb. J Laryngol Otol. 114(11):867-9, 2000
                                                                              9. Weissman JL et al: Imaging of tinnitus: a review. Radiology. 216(2):342-9, 2000
                                                                              10. Couloigner V et al: Surgical treatment of the high jugular bulb in patients with Meniere's disease and pulsatile tinnitus. Eur Arch Otorhinolaryngol. 256(5):224-9, 1999
                                                                              11. Saito T et al: High jugular bulb adhering to the eardrum. Ann Otol Rhinol Laryngol. 108(6):620-2, 1999
                                                                              12. Tekdemir I et al: The jugular foramen: a comparative radioanatomic study. Surg Neurol. 50(6):557-62, 1998
                                                                              13. Caldemeyer KS et al: The jugular foramen: a review of anatomy, masses, and imaging characteristics. Radiographics. 17(5):1123-39, 1997
                                                                              14. Weiss RL et al: High jugular bulb and conductive hearing loss. Laryngoscope. 107(3):321-7, 1997
                                                                              15. Atilla S et al: Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol. 20(1):52-6, 1995
                                                                              16. Tomura N et al: Normal variations of the temporal bone on high-resolution CT: their incidence and clinical significance. Clin Radiol. 50(3):144-8, 1995
                                                                              17. Dietz RR et al: MR imaging and MR angiography in the evaluation of pulsatile tinnitus. AJNR Am J Neuroradiol. 15(5):879-89, 1994
                                                                              18. Shotton JC et al: Temporal bone venous anomaly of surgical significance. J Laryngol Otol. 103(1):101-6, 1989
                                                                              19. Mueller DP et al: Enlarged jugular foramen. Ann Otol Rhinol Laryngol. 97(3 Pt 1):326-7, 1988
                                                                              20. Smith B et al: Dehiscent jugular bulb. Ann Otol Rhinol Laryngol. 96(2 Pt 1):232-3, 1987
                                                                              21. Daniels DL et al: Jugular foramen: anatomic and computed tomographic study. AJR Am J Roentgenol. 142(1):153-8, 1984
                                                                              22. Lo WW et al: High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology. 150(3):743-7, 1984
                                                                              23. Ongre A: The jugular bulb once more. AJR Am J Roentgenol. 135(5):1117, 1980