A high placed jugular bulb in the middle ear: A clinical and temporal bone study

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Abstract
Anatomically, the superior boundary of the jugular bulb lies below the floor of the hypotympanum of the middle ear space. In a rare instance, it can extend upward, elevate the floor of the hypotympanum and present in the middle ear. This elevation is an anomaly well known but rarely witnessed or documented in the literature. This may result in serious hemorrhage at the time of surgery if unrecognized by the surgeon and if it is injured during temporal bone surgery.Two hundred fifty‐seven histologically prepared temporal bones were examined microscopically for anomalous positions of the jugular bulb. This survey represents 189 patients. Thirteen temporal bones were found in which the jugular bulb extended into the middle ear space above the inferior rim of the bony annulus. Although this anatomical variation occurs infrequently in the general population, a 6 percent incidence of high placed jugular bulb in the middle ear was found in the temporal bones studied in this series.