Surgical treatment of the high jugular bulb by compressing sinus sigmoideus: two cases.
If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no flow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and different treatment perspectives accompanied by literature.
Oztürkcan
Sedat
S
Department of Otorhinolaryngology and Head and Neck Surgery, Atatürk Research and Training Hospital, Ministry of Health, Izmir, Turkey. seralbercan@yahoo.com
Katilmiş
Hüseyin
H
Ozkul
Yilmaz
Y
Erdoğan
Nezahat
N
Başoğlu
Sinan
S
Tayfun
Mehmet Ali
MA
D000293:Adolescent; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D002648:Child; D003392:Cranial Sinuses / Q000601:surgery*; D004338:Drug Combinations; D005260:Female; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007601:Jugular Veins / Q000002:abnormalities* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008416:Mastoid / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000379:methods*; D010168:Palmitates / Q000627:therapeutic use; D013701:Temporal Bone / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000601:surgery; D014885:Waxes / Q000627:therapeutic use
D002483:Cellulose, Oxidized; D004338:Drug Combinations; D006490:Hemostatics; D010168:Palmitates; D014885:Waxes; C055480:bone wax; C013695:Surgicel