Audiology and Neurotology
Original Paper
High Computed Tomographic Correlations between Carotid Canal Dehiscence and High Jugular Bulb in the Middle EarWang C.-H.a, b · Shi Z.-P.a · Liu D.-W.c, d · Wang H.-W.a · Huang B.-R.a · Chen H.-C.aaDepartment of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, and bInstitute of Microbiology and Immunology, National Defense Medical Center, Taipei, cDepartment of Radiation Oncology, Buddhist Tzu Chi General Hospital, and dDepartment of Radiology, Tzu Chi University, Hualien, Taiwan, ROC
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Article / Publication Details
Received: July 29, 2009
Accepted: April 27, 2010
Published online: July 07, 2010
Issue release date: January 2011
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3
ISSN: 1420-3030 (Print)
eISSN: 1421-9700 (Online)
For additional information: https://www.karger.com/AUD
Abstract
Both carotid canal dehiscence (CCD) and high jugular bulb (HJB) are thought to increase the potential for disastrous consequences during middle ear surgery. Clinical co-presentation of these two great vessel variants has not yet been described. This study aims to determine the relationship between CCD and HJB based on a computed tomographic (CT) temporal bone evaluation. High-resolution CT scans of 408 temporal bones obtained from 208 adults were recruited. Carotid canal integrity, jugular bulb position, petrous apex pneumatization and the minimal thickness of the carotid canal wall (TCW) facing the tympanic cavity were examined and measured for the incidence of CCD and/or HJB. Other variables including gender, age, laterality and the presence of otitis media or mastoiditis were also collected for analysis. CCD was found in 28 ears (6.9%); 19 of these were found to also have HJB (67.9%). The presence of CCD was significantly correlated with HJB presentation. The minimal TCW in HJB ears was significantly thinner than that of normally positioned jugular bulbs. Moreover, after controlling for other candidate variables, the independent factors of age (younger or older than 50 years) and jugular bulb position (high vs. normal) were found to predict the presence of CCD. In conclusion, HJB tends to coexist with a thinner carotid canal wall. This finding emphasizes the need to be watchful for the coexistence of these two great vessel anomalies when surgeons encounter an aged patient presenting either CCD or HJB during middle ear surgery.
© 2010 S. Karger AG, Basel
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References
- Atilla S, Akpek S, Uslu S, Ilgit ET, Isik S: Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol 1995;20:52–56.
-
Califano J, Bhatti NI, Niparko JK: Imaging quiz case 2: jugular bulb dehiscence. Arch Otolaryngol Head Neck Surg 1998;124:1047, 1049–1050.
- Glasscock ME 3rd, Dickins JR, Jackson CG, Wiet RJ: Vascular anomalies of the middle ear. Laryngoscope 1980;90:77–88.
- Glasscock ME 3rd, Seshul M, Seshul MB Sr: Bilateral aberrant internal carotid artery case presentation. Arch Otolaryngol Head Neck Surg 1993;119:335–339.
- Graham MD: The jugular bulb: its anatomic and clinical considerations in contemporary otology. Laryngoscope 1977;87:105–125.
- Han SJ, Song MH, Kim J, Lee WS, Lee HK: Classification of temporal bone pneumatization based on sigmoid sinus using computed tomography. Clin Radiol 2007;62:1110–1118.
- Hasebe S, Sando I, Orita Y: Proximity of carotid canal wall to tympanic membrane: a human temporal bone study. Laryngoscope 2003;113:802–807.
- Huang BR, Wang CH, Young YH: Dehiscent high jugular bulb: a pitfall in middle ear surgery. Otol Neurotol 2006;27:923–927.
- Kawano H, Tono T, Schachern PA, Paparella MM, Komune S: Petrous high jugular bulb: a histological study. Am J Otolaryngol 2000;21:161–168.
- Koesling S, Kunkel P, Schul T: Vascular anomalies, sutures and small canals of the temporal bone on axial CT. Eur J Radiol 2005;54:335–343.
- Morantz RA, Kirchner FR, Kishore P: Aneurysms of the petrous portion of the internal carotid artery. Surg Neurol 1976;6:313–318.
- Moreano EH, Paparella MM, Zelterman D, Goycoolea MV: Prevalence of carotid canal dehiscence in the human middle ear: a report of 1000 temporal bones. Laryngoscope 1994;104:612–618.
- Mutlu C, da Costa SS, Paparella MM, Schachern PA: Clinical-histopathological correlations of pitfalls in middle ear surgery. Eur Arch Otorhinolaryngol 1998;255:189–194.
- Overton SB, Ritter FN: A high placed jugular bulb in the middle ear: a clinical and temporal bone study. Laryngoscope 1973;83:1986–1991.
- Ozturkcan S, Katilmis H, Ozkul Y, Erdogan N, Basoglu S, Tayfun MA: Surgical treatment of the high jugular bulb by compressing sinus sigmoideus: two cases. Eur Arch Otorhinolaryngol 2008;265:987–991.
-
Penido Nde O, Borin A, Fukuda Y, Lion CN: Microscopic anatomy of the carotid canal and its relations with cochlea and middle ear. Braz J Otorhinolaryngol 2005;71:410–414.
- Sauvaget E, Paris J, Kici S, Kania R, Guichard JP, Chapot R, Thomassin JM, Herman P, Tran Ba Huy P: Aberrant internal carotid artery in the temporal bone: imaging findings and management. Arch Otolaryngol Head Neck Surg 2006;132:86–91.
- Savic D, Djeric D: Anatomical variations and relations in the medial wall of the bony portion of the eustachian tube. Acta Otolaryngol 1985;99:551–556.
- Savic D, Djeric D: Surgical anatomy of the hypotympanum. J Laryngol Otol 1987;101:419–425.
- Saylam G, Tulgar M, Saatci I, Korkmaz H: Iatrogenic carotid artery pseudoaneurysm presenting with conductive hearing loss. Am J Otolaryngol 2009;30:141–144.
- Schelling F: The emissaries of the human skull (in German, author’s translation). Anat Anz 1978;143:340–382.
- Shao KN, Tatagiba M, Samii M: Surgical management of high jugular bulb in acoustic neurinoma via retrosigmoid approach. Neurosurgery 1993;32:32–36; discussion 36–37.
- Wadin K, Wilbrand H: The topographic relations of the high jugular fossa to the inner ear: a radioanatomic investigation. Acta Radiol Diagn (Stockh) 1986;27:315–324.
- Welling DB, Glasscock ME 3rd, Tarasidis N: Management of carotid artery hemorrhage in middle ear surgery. Otolaryngol Head Neck Surg 1993;109:996–999.
- Windfuhr JP: Aberrant internal carotid artery in the middle ear. Ann Otol Rhinol Laryngol Suppl 2004;192:1–16.
Article / Publication Details
Received: July 29, 2009
Accepted: April 27, 2010
Published online: July 07, 2010
Issue release date: January 2011
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3
ISSN: 1420-3030 (Print)
eISSN: 1421-9700 (Online)
For additional information: https://www.karger.com/AUD
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