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Aging and disease    2020, Vol. 11 Issue (4) : 770-776     DOI: 10.14336/AD.2020.0215
Orginal Article |
Prevalence of High Jugular Bulb across Different Stages of Adulthood in A Chinese Population
Wang Jingjing1,2,3, Feng Yanmei1,2,3, Wang Hui1,2,3, Li Chunyan1,2,3, Wu Yaqin1,2,3, Shi Haibo1,2,3, Yin Shankai1,2,3,*, Chen Zhengnong1,2,3,*
1Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
2Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China
3Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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Abstract  

Pulsatile tinnitus, ear fullness, vertigo, hearing disorders, and vestibular dysfunction have been found to be related to high jugular bulb. Anatomical variation in this region also affects surgical planning and approaches. Therefore, knowledge on the detailed anatomy of the high jugular bulb is critical for middle ear and lateral skull base surgery. Prevalence of high jugular bulb is uncertain as data are usually derived from temporal bone specimens and patient reports from hospitals. Therefore, a community-based epidemiological study is necessary to understand the significance of high jugular bulb anatomy. Here, we report a cross-sectional study to characterize the prevalence of high jugular bulb and jugular bulb size using a 3.0 T magnetic resonance imaging. Furthermore, we studied the relationship between the prevalence of high jugular bulb and age-related changes. We enrolled 4539 permanent residents (9078 ears) from two communities in the Shanghai region who underwent magnetic resonance imaging between 2007 and 2011. We divided participants into four subgroups according to age: 35-44 (early middle age), 45-54 (middle age), 55-64 (late middle age), and 65-75 (late adulthood) years. We found that the overall prevalence of high jugular bulb was 14.5% in a Chinese population. There was a higher prevalence of high jugular bulb on the right side and especially in women (both p < 0.001). The occurrence of high jugular bulb was higher in the early middle age group and gradually decreased with age, but was still present in the late adulthood group (p = 0.039). These findings provide useful information on the prevalence of high jugular bulb in a Chinese population and the distribution in age groups, suggesting that high jugular bulb should be considered, even in those without ear disorders. This work serves as a foundation for further research on the relationship between jugular bulb changes and disease symptoms.

Keywords high jugular bulb      jugular bulb      age      prevalence      Chinese population     
Corresponding Authors: Yin Shankai,Chen Zhengnong   
About author:

These authors contributed equally to this work.

Just Accepted Date: 17 February 2020   Issue Date: 30 July 2020
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Wang Jingjing
Feng Yanmei
Wang Hui
Li Chunyan
Wu Yaqin
Shi Haibo
Yin Shankai
Chen Zhengnong
Cite this article:   
Wang Jingjing,Feng Yanmei,Wang Hui, et al. Prevalence of High Jugular Bulb across Different Stages of Adulthood in A Chinese Population[J]. Aging and disease, 2020, 11(4): 770-776.
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http://www.aginganddisease.org/EN/10.14336/AD.2020.0215     OR
CharacteristicsTotal
(N=4539)
Normal jugular bulb
(normal JB, n=3883)
High jugular bulb
(HJB, n=656)
P value*
Mean age (SD), y55.5 (10.1)55.6 (10.1)54.6 (10.1)0.027*
Female/Male, n/n2395/21442005/1878390/266<0.001*
Mean body mass index (SD), kg/m223.6 (3.0)23.7 (3.0)23.5 (3.1)0.049*
Smoking, n (%)+981 (21.6%)859 (22.1%)122 (18.6%)0.043*
Alcohol use, n (%)#569 (12.5%)492 (12.7%)77 (11.7%)0.505
Hypertension, n (%)1147 (25.3%)999 (25.7%)148 (22.6%)0.084
Diabetes, n (%)329 (7.2%)278 (7.2%)51 (7.8%)0.574
Hyperlipidemia, n (%)357 (7.9%)311 (8.0%)46 (7.0%)0.380
Stroke, n (%)134 (3.0%)116 (3.0%)18 (2.7%)0.733
Coronary heart disease, n (%)96 (2.1%)87 (2.2%)9 (1.4%)0.153
Myocardial infarction, n (%)16 (0.4%)15 (0.4%)1 (0.2%)0.563
Arrhythmia, n (%)84 (1.9%)75 (1.9%)9 (1.4%)0.325
Table 1  Study participant characteristics.
Figure 1.  Age-related HJB prevalence and MR images of different JB types. (A) The prevalence of HJB (%) across age groups. (B) Axial MR images showing dynamic changes in the normal JB. (a) A JB reaching the cochlea basal turn; (b) the JB was not seen at the level of the internal auditory canal. (C) Axial MR images showing dynamic changes in the HJB. (a) A JB reaching the cochlea basal turn; (b) a JB rising above the cochlear basal turn and inferior to the internal auditory canal; (c) the HJB extending superiorly to the internal auditory canal. HJB = high jugular bulb; MR = magnetic resonance; JB = jugular bulb.

Age (yrs)
Men
Women
All
Participants (N)Area (mm2)
P1Participants (N)Area (mm2)
P2Participants (N)Area (mm2)
P3
LeftRightLeftRightLeftRight
35-4438447.6 (23.2)59.7 (30.0)<0.00138547.3 (27.9)57.6 (31.8)<0.00176947.4(25.7)58.6(30.9)<0.001
45-5468647.8 (25.6)59.4 (31.3)<0.00185844.9 (25.1)55.7 (30.3)<0.001154446.2(25.4)57.3(30.8)<0.001
55-6457745.9 (26.7)62.3 (33.6)<0.00166843.2 (25.1)57.3 (31.3)<0.001124544.5(25.9)59.6(32.5)<0.001
65-7549742.4 (25.4)56.4 (29.5)<0.00148442.7 (26.1)56.2 (31.4)<0.00198142.5(25.7)56.3(30.5)<0.001
Total214446.0 (25.5)59.5 (31.3)<0.001239544.3 (25.8)56.6 (31.1)<0.001453945.1(25.7)58.0(31.2)<0.001
Table 2  Age- and sex-specific area of the JB [normal jugular bulb (normal JB) + high jugular bulb (HJB)].
Age
(yrs)
Men
Women
All
Normal JB
HJB
P1Normal JB
HJB
P2Normal JB
HJB
P3
Ears
(n)
Area (mm2)Ears
(n)
Area (mm2)Ears
(n)
Area (mm2)Ears
(n)
Area (mm2)Ears
(n)
Area (mm2)Ears
(n)
Area (mm2)
35-4465252.0 (25.4)11662.6 (36.2)0.01361649.8 (28.6)15462.9 (34.6)<0.001126851.0 (27.0)27062.8 (35.2)<0.001
45-54121052.0 (27.9)16265.8 (34.7)<0.001144847.6 (26.5)26864.8 (33.1)<0.001265849.6 (27.2)43065.2 (33.7)<0.001
55-64101852.2 (29.1)13668.8 (42.4)<0.001111247.2 (27.0)22465.1 (35.0)<0.001213049.6 (28.1)36066.5 (37.9)<0.001
65-7587647.5 (27.0)11863.6 (34.0)<0.00183446.5 (26.9)13468.0 (38.0)<0.001171047.0 (27.0)25265.9 (36.2)<0.001
Total375651.0 (27.7)53265.4 (36.9)<0.001401047.6 (27.1)78065.1 (34.8)<0.001776649.2 (27.4)131265.2 (35.7)<0.001
Table 3  Age- and sex-specific area of different JB types [normal jugular bulb (normal JB) or high jugular bulb (HJB)].
[1] Huang BR, Wang CH, Young YH (2006). Dehiscent high jugular bulb: a pitfall in middle ear surgery. Otol Neurotol, 27:923-927.
[2] Redfern RE, Brown M, Benson AG (2014). High jugular bulb in a cohort of patients with definite Meniere's disease. J Laryngol Otol, 128:759-764.
[3] Atilla S, Akpek S, Uslu S, Ilgit ET, Isik S (1995). Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone. Eur J Radiol, 20:52-56.
[4] Kawano H, Tono T, Schachern PA, Paparella MM, Komune S (2000). Petrous high jugular bulb: a histological study. Am J Otolaryngol, 21:161-168.
[5] Friedmann DR, Eubig J, Winata LS, Pramanik BK, Merchant SN, Lalwani AK (2012). A clinical and histopathologic study of jugular bulb abnormalities. Arch Otolaryngol Head Neck Surg, 138:66-71.
[6] Atmaca S, Elmali M, Kucuk H (2014). High and dehiscent jugular bulb: clear and present danger during middle ear surgery. Surg Radiol Ana, 36:369-374.
[7] Fujimoto C, Ito K, Ishimoto S, Iwasaki S (2007). Large jugular bulb diverticulum invading the internal auditory canal. Ann Otol Rhinol Laryngol, 116:631-636.
[8] Vachata P, Petrovicky P, Sames M (2010). An anatomical and radiological study of the high jugular bulb on high-resolution CT scans and alcohol-fixed skulls of adults. J Clin Neurosci, 17:473-478.
[9] Bilgen C, Kirazli T, Ogut F, Totan S (2003). Jugular bulb diverticula: clinical and radiologic aspects. Otolaryngol Head Neck Surg, 128:382-386.
[10] Hourani R, Carey J, Yousem DM (2005). Dehiscence of the jugular bulb and vestibular aqueduct: findings on 200 consecutive temporal bone computed tomography scans. J Comput Assist Tomogr, 29:657-662.
[11] Sayit AT, Gunbey HP, Fethallah B, Gunbey E, Karabulut E (2016). Radiological and audiometric evaluation of high jugular bulb and dehiscent high jugular bulb. J Laryngol Otol, 130:1059-1063.
[12] Ball M, Elloy M, Vaidhyanath R, Pau H (2010). Beware the silent presentation of a high and dehiscent jugular bulb in the external ear canal. J Laryngol Otol, 124:790-792.
[13] Woo CK, Wie CE, Park SH, Kong SK, Lee IW, Goh EK (2012). Radiologic analysis of high jugular bulb by computed tomography. Otol Neurotol, 33:1283-1287.
[14] Manjila S, Bazil T, Kay M, Udayasankar UK, Semaan M (2018). Jugular bulb and skull base pathologies: proposal for a novel classification system for jugular bulb positions and microsurgical implications. Neurosurg Focus, 45:E5.
[15] Fox R, Nash R, Tatla T (2017). Encountering a high jugular bulb during ear surgery. Ann R Coll Surg Engl, 99:36-37.
[16] Park JJ, Shen A, Keil S, Kuhl C, Westhofen M (2015). Jugular bulb abnormalities in patients with Meniere's disease using high-resolution computed tomography. Eur Arch Otorhinolaryngol, 272:1879-1884.
[17] Brook CD, Buch K, Kaufmann M, Sakai O, Devaiah AK (2015). The Prevalence of High-Riding Jugular Bulb in Patients with Suspected Endolymphatic Hydrops. J Neurol Surg B Skull Base, 76:471-474.
[18] Kennedy DW, el-Sirsy HH, Nager GT (1986). The jugular bulb in otologic surgery: anatomic, clinical, and surgical considerations. Otolaryngol Head Neck Surg, 94:6-15.
[19] El-Begermy MA, Rabie AN (2010). A novel surgical technique for management of tinnitus due to high dehiscent jugular bulb. Otolaryngol Head Neck Surg, 142:576-581.
[20] Tsunoda A (2000). Sensorineural hearing loss caused by a high jugular bulb. J Laryngol Otol, 114:867-869.
[21] Singla A, Gupta T, Sahni D, Aggarwal A, Gupta A (2016). High jugular bulb: different osseous landmarks and their clinical implications. Surg Radiol Anat, 38:903-909.
[22] Friedmann DR, Eubig J, McGill M, Babb JS, Pramanik BK, Lalwani AK (2011). Development of the jugular bulb: a radiologic study. Otol Neurotol, 32:1389-1395.
[23] Friedmann DR, Eubig J, Winata LS, Pramanik BK, Merchant SN, Lalwani AK (2012). Prevalence of jugular bulb abnormalities and resultant inner ear dehiscence: a histopathologic and radiologic study. Otolaryngol Head Neck Surg, 147:750-756.
[24] Okudera T, Huang YP, Ohta T, Yokota A, Nakamura Y, Maehara F, et al. (1994). Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol, 15:1871-1883.
[25] Li MH, Chen SW, Li YD, Chen YC, Cheng YS, Hu DJ, et al. (2013). Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years: a cross-sectional study. Ann Intern Med, 159:514-521.
[26] Wang CH, Shi ZP, Liu DW, Wang HW, Huang BR, Chen HC (2011). High computed tomographic correlations between carotid canal dehiscence and high jugular bulb in the middle ear. Audiol Neurootol, 16:106-112.
[27] Koesling S, Kunkel P, Schul T (2005). Vascular anomalies, sutures and small canals of the temporal bone on axial CT. Eur J Radiol, 54:335-343.
[28] Van Gompel JJ, Patel J, Danner C, Zhang AN, Samy Youssef AA, van Loveren HR, et al. (2013). Acoustic neuroma observation associated with an increase in symptomatic tinnitus: results of the 2007-2008 Acoustic Neuroma Association survey. J Neurosurg, 119:864-868.
[29] Roche PH, Moriyama T, Thomassin JM, Pellet W (2006). High jugular bulb in the translabyrinthine approach to the cerebellopontine angle: anatomical considerations and surgical management. Acta Neurochir (Wien), 148:415-420.
[30] Bozek P, Kluczewska E, Misiolek M, Scierski W, Lisowska G (2016). The Prevalence of Persistent Petrosquamosal Sinus and Other Temporal Bone Anatomical Variations on High-Resolution Temporal Bone Computed Tomography. Med Sci Monit, 22:4177-4185.
[31] Matthies C, Samii M, Krebs S (1997). Management of vestibular schwannomas (acoustic neuromas): radiological features in 202 cases--their value for diagnosis and their predictive importance. Neurosurgery, 40:469-481; discussion 481-462.
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