Abstract

Pulsatile tinnitus, ear fullness, vertigo, hearing disorders, and vestibular dysfunction have been found to be related to high jugular bulb. Anatomical variation in this region also affects surgical planning and approaches. Therefore, knowledge on the detailed anatomy of the high jugular bulb is critical for middle ear and lateral skull base surgery. Prevalence of high jugular bulb is uncertain as data are usually derived from temporal bone specimens and patient reports from hospitals. Therefore, a community-based epidemiological study is necessary to understand the significance of high jugular bulb anatomy. Here, we report a cross-sectional study to characterize the prevalence of high jugular bulb and jugular bulb size using a 3.0 T magnetic resonance imaging. Furthermore, we studied the relationship between the prevalence of high jugular bulb and age-related changes. We enrolled 4539 permanent residents (9078 ears) from two communities in the Shanghai region who underwent magnetic resonance imaging between 2007 and 2011. We divided participants into four subgroups according to age: 35-44 (early middle age), 45-54 (middle age), 55-64 (late middle age), and 65-75 (late adulthood) years. We found that the overall prevalence of high jugular bulb was 14.5% in a Chinese population. There was a higher prevalence of high jugular bulb on the right side and especially in women (both p < 0.001). The occurrence of high jugular bulb was higher in the early middle age group and gradually decreased with age, but was still present in the late adulthood group (p = 0.039). These findings provide useful information on the prevalence of high jugular bulb in a Chinese population and the distribution in age groups, suggesting that high jugular bulb should be considered, even in those without ear disorders. This work serves as a foundation for further research on the relationship between jugular bulb changes and disease symptoms.

Highlights

  • Jugular bulb (JB) is the jugular vein blood vessels in a corner of extracranial, shaped like a ball, with its wall thin and vulnerable

  • The prevalence of high jugular bulbs (HJBs) decreased with age

  • We found that the prevalence of HJB was 14.5% (656/4539) in a large, healthy Chinese population

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Summary

Introduction

Jugular bulb (JB) is the jugular vein blood vessels in a corner of extracranial, shaped like a ball, with its wall thin and vulnerable. An HJB may cause vertigo and other vestibular dysfunctions by preventing the vestibular aqueduct from reabsorbing endolymph, which subsequently causes Meniere’s disease [8, 21] Given these relationships to clinical disease, it is important to obtain more knowledge of the anatomy of HJBs. Previous studies have reported that JB development continues for an extended period of time postnatally [2224]. One prior histopathologic study reported the frequency of JB abnormalities by decade of life, studies which exclusively focus on the age-related prevalence of HJB are lacking [23]. Otologists should be aware of variations in HJB anatomy in particular populations

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