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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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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   
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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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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)
Participants (N)Area (mm2)
P1Participants (N)Area (mm2)
P2Participants (N)Area (mm2)
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)].
Normal JB
P1Normal JB
P2Normal JB
Area (mm2)Ears
Area (mm2)Ears
Area (mm2)Ears
Area (mm2)Ears
Area (mm2)Ears
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)].
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