Attic Cholesteatoma and High Riding Jugular Bulb: a Rare Cause of Conductive Hearing Loss

Authors: Monsalve Santiago* and Jorge V

DOI: 10.23880/ooaj-16000302

Volume 10, Issue 1

Abstract

The jugular bulb corresponds to the most cranial part of the internal jugular vein and is intimately related to the middle ear forming its floor or fundus tympani. In the embryological development, different anatomical alterations of this region can be manifested, such as a high riding and dehiscent jugular bulb, a protruding bulb with preservation of its bony structure or jugular bulb diverticulum. This anatomical variant is asymptomatic in most cases. However, depending on the size of the jugular height and its relationships, it could generate otologic symptoms such as tinnitus, fullness and, more rarely, conductive hearing loss. We report a case of a pathological association consisting of an attic cholesteatoma and a high riding jugular bulb in the left ear of a female patient who consulted for conductive hearing loss, aural fullness and pulsatile tinnitus. In this case, endoscopic intervention of the attic cholesteatoma was decided, taking care to avoid inadvertently injuring the venous gulf. Thus, the removal of the incus, the head of the malleus and the cholesteatoma was performed in a transcanal fashion. Subsequently, tragus cartilage was placed to repair the attic and over the stapes head to improve sound transmission.

Keywords: Hearing Loss; Attic Cholesteatoma; Jugular Bulb

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