Jugular bulb abnormalities in patients with Ménière's disease using high-resolution computed tomography.

Abstract

Temporal bone abnormalities such as hypoplasia of the vestibular aqueduct or hypopneumatization of the mastoid have been described in Meniere’s disease (MD). Jugular bulb abnormalities (JBA) are one of the most common temporal bone abnormalities. The aim of this study was to evaluate the frequency of JBA in MD. Radiological data obtained by temporal bone high-resolution computed tomography of 200 ears of 167 MD patients (MD group) and 218 ears of 109 patients with normal inner ear function (control group) were analyzed retrospectively. The frequencies of high jugular bulb (HJB), jugular bulb diverticulum (JBD), inner ear adjacent jugular bulb (IAJB) and jugular bulb related inner ear dehiscence (JBID) were evaluated and compared between MD group and control group. IAJB was differentiated into vestibular aqueduct adjacent jugular bulb (VAAJB), cochlear aqueduct adjacent jugular bulb and posterior semicircular canal adjacent jugular bulb. JBID was further analyzed by differentiating into jugular bulb related vestibular aqueduct dehiscence (JBVAD), jugular bulb related cochlear aqueduct dehiscence and jugular bulb related posterior semicircular canal dehiscence. The frequencies of HJB, JBD and IAJB were higher in MD group compared to control group (21, 13.3 %, p = 0.036; 8.5, 3.7 %, p = 0.037; 13.5, 4.6 %, p = 0.001). No differences between both groups were seen in JBID (4.0, 2.3 %, p = 0.315). Most IAJB and JBID were seen in VAAJB and JBVAD. There is a higher frequency of JBA in patients with MD than in patients without inner ear symptoms. Temporal bones of MD patients might be constituted anatomically different, carrying predisposing factors for the development of clinically apparent MD.