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Anatomical considerations of high jugular bulb in lateral skull base surgery

Published online by Cambridge University Press:  29 June 2007

Asim Aslan ,
Maurizio Falcioni ,
Alessandra Russo ,
Giuseppe De Donato ,
Fatih Ridvan Balyan ,
Abdelkader Taibah  and
Mario Sanna
Asim Aslan*
Affiliation:
1st ENT Clinic of Numune State Hospital, Ankara, Turkey.
Maurizio Falcioni
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Alessandra Russo
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Giuseppe De Donato
Affiliation:
1st ENT Clinic of Numune State Hospital, Ankara, Turkey. Gruppo Otologico, Piacenza, Italy.
Fatih Ridvan Balyan
Affiliation:
2nd ENT Clinic of Numune State Hospital, Ankara, Turkey.
Abdelkader Taibah
Affiliation:
Gruppo Otologico, Piacenza, Italy.
Mario Sanna
Affiliation:
Gruppo Otologico, Piacenza, Italy.
*
Address for correspondence: Asim Aslan, M.D., Harbiye Mah., Veznedar Sok. 18/14, 06460 Dikmen-Ankara, Turkey. Fax: 312-4335024
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Abstract

In order to study high jugular bulb management in lateral skull base surgery, an anatomical study was conducted on 30 temporal bones by examining the relationship between the internal auditory canal (IAC) and the jugular bulb. The following parameters were measured: 1) Height of the jugular bulb (H) … distance between the level of the jugular bulb dome and the line passing through the confluence of the sigmoid sinus with the jugular bulb (SS-JB), 2) Mastoid length (ML) … distance between the mastoid process and middle cranial fossa dura, 3) Distance between the most inferior part of the porus acousticus and jugular bulb dome (A), 4) Distance between the porus acousticus and SS-JB (B). The jugular bulb was defined as high when it occupied more than two thirds of (B). The incidence of a high jugular bulb was 23 per cent in this study. When the jugular bulb was high, the mean (H) and (A) were 9.4 ± 1.9 mm and 2.7 ± 0.5 mm, respectively. (H) was higher on the right side than on the left side. No statistically significant difference was found between small and large mastoids (t-test: p>0.05). It was concluded that when a high jugular bulb was encountered during lateral skull base surgery, the jugular bulb position allows a very small working area inferior to the IAC. In these cases, a 3 or 4 mm depression of the jugular bulb is necessary in order to expose the lower cranial nerves. This can be accomplished by lowering the jugular bulb with the technique already described.

Keywords

AnatomyTemporal bone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 4 , April 1997 , pp. 333 - 336
Copyright
Copyright © JLO (1984) Limited 1997

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Footnotes

Supported by a grant from the Associazione Studio Aggiornamento Basicranio (A.S.A.B.).

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