An analysis of correlation between the unusual location of the jugular bulb and audiovestibular symptoms.
OBJECTIVE
Case reports indicate that abnormal location of the jugular bulb (JB) may result with some vestibular and audiological symptoms. The aim of this study is to analyze the correlation between the radiological view of the JB and audiovestibular findings and to clarify its possible role for Meniere-like problems.


METHODS
Fifty-six patients, who had abnormal view of the JB on computerized tomography (CT) were selected to the study in this prospective case review. They were classified in three groups (Group-I; Lateral, Group-II; Intermediate and Group-III; Medial), according to the location of the JB. Patients were subjected to audiogram and vestibular tests (Dix-Hallpike maneuver, fistula test, vestibulospinal tests, electronystagmography (ENG)).


RESULTS
JB was compressing on the cochlear aqueduct (CA) in two patients in group-II. Seventeen out of 25 patients in group-III had radiological evidence of obstruction of vestibular aqueduct (VA). 19 patients had neurosensorial and four patients had conductive hearing loss. All of the patients in group-I and nine of the patients in group-II gave normal caloric response to stimulation. Twelve of 19 patients in group-III demonstrated canal paresis ranging from 22 to 80%.


CONCLUSIONS
Present study points out that there is a high correlation between HJB and vestibular problems in symptomatic cases. In patients who have HJB without classic vertigo attacks subclinical involvement of the vestibular system has been observed on ENG recordings. These findings imply that radiological existence of HJB may be a predisposing factor for Meniere-like complaints.
Yetiser
Sertac
S
Department of ORL and HNS, Gülhane Medical School, Etlik, 06018 Ankara, Turkey. syetiser@yahoo.com
Kertmen
Mustafa
M
Yildirim
Altan
A
D004584:Electronystagmography; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007601:Jugular Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014723:Vestibular Aqueduct / Q000000981:diagnostic imaging / Q000503:physiopathology; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology