title: Development of the jugular bulb: a radiologic study.
abstract: OBJECTIVE
  Jugular bulb (JB) abnormalities such as JB diverticulum and high-riding JBs of the temporal bone can erode into the inner ear and present with hearing loss, vestibular disturbance, and pulsatile tinnitus. Their cause and potential to progress remain to be studied. This comprehensive radiologic study investigates the postnatal development of the venous system from transverse sinus to internal jugular vein (IJV).
  
  
  METHODS
  Academic medical center. PATIENTS, INTERVENTION, MAIN OUTCOME MEASURE: Measurements of the transverse and sigmoid sinus, the JB, IJV, and carotid artery were made from computed tomographic scans of the neck with intravenous contrast in infants (n = 5), children (n = 13), adults (n = 35), and the elderly (n = 15).
  
  
  RESULTS
  Jugular bulbs were not detected in patients younger than 2 years, enlarged in adulthood, and remained stable in the elderly. The venous system was larger in men than in women. From transverse sinus to IJV, the greatest variation in size was just proximal and distal to the JB with greater symmetry observed as blood returned to the heart. Right-sided venous dominance was most common occurring in 70% to 80% of cases.
  
  
  CONCLUSIONS
  The JB is a dynamic structure that forms after 2 years, and its size stabilizes in adulthood. The determinants in its exact position and size are multifactorial and may be related to blood flow. Improved understanding of this structure's development may help to better understand the cause of the high-riding JB and JB diverticulum, both of which may cause clinical symptoms.
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, New York, New York 10016, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Friedmann
authors.forename: Jan
authors.initials: J
authors.lastname: Eubig
authors.forename: Megan
authors.initials: M
authors.lastname: McGill
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.forename: Bidyut K
authors.initials: BK
authors.lastname: Pramanik
authors.forename: Anil K
authors.initials: AK
authors.lastname: Lalwani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D013701:Temporal Bone / Q000000981:diagnostic imaging