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Abstract Cephalad displacement of the internal jugular vein with exposed superior jugular bulb in the middle ear cavity is an anatomical variation that may have a segmental bluish discoloration through the tympanic membrane. This abnormality may be associated with a conductive or sensorineural hearing loss. Three cases with bluish-appearing retrotympanic masses were recently explored, and an aberrant jugular bulb was found to be the cause in each case. The audiogram in each case was different. Two of the patients were dwarfs with similar forms of chondrodystrophy— achondroplasia and hypochondroplasia. In achondroplasia, secondary irregular ossification of membranous bone at the base of the skull occurs and may lead to a greater risk of vascular anomalies in the middle ear cavity. References 1. Bak-Pedesen K, Tos M: Pathogenesis of idiopathic hemotympanum . J Laryngol Otol 86:473-485, 1972.Crossref 2. Shambaugh GE: Surgery of the Ear , ed 2. Philadelphia, WB Saunders Co, 1969, p 640. 3. Steffen TN: Vascular anomalies of the middle ear . Laryngoscope 78:171-197, 1968.Crossref 4. Paparella MM, Lim JD: Pathogenesis and pathology of the "idiopathic" blue ear drum . Arch Otolaryngol 85:249-258, 1967.Crossref 5. Page JR: Injury to jugular bulb following myringotomy . Ann Otol Rhinol Laryngol 23:161-163, 1914. 6. Hough JVD: Congenital malformations of the middle ear . Arch Otolaryngol 78:335-343, 1963.Crossref 7. Hough JVD: Malformations and anatomical variations seen in middle ear during operation for mobilization of the stapes . Laryngoscope 68:1337-1379, 1958.Crossref 8. Smythe GD, Black JHA: A case report of protruding jugular bulb . Laryngoscope 75:669-672, 1965. 9. Overton SB, Ritter FN: A high placed jugular bulb in the middle ear. A clinical and temporal bone study . Laryngoscope 83:1986-1991, 1973.Crossref 10. Histelberger WE, Witten RM: Jugular venography . Arch Otolaryngol 89:167-169, 1969.Crossref 11. Poser CM, Taveras JM: Clinical aspects of cerebral angiography in children . Pediatrics 16:73-79, 1955. 12. Cornell S: Jugular venography . Am J Roentgenol Radium Ther Nucl Med 106:303-307, 1969.Crossref 13. Tonndorf J, Tabor J: Closure of the cochlear window: Its effect upon air and bone conduction . Ann Otol Rhinol Laryngol 71:5-29, 1962. 14. Tonndorf J, Etol: Quantitative evaluation of bone conduction components in cats . Acta Otolaryngol (Stockh) (Suppl 213) , pp 10-38, 1966. 15. Groen JJ, Hoagland GA: Bone conduction and otosclerosis of the round window . Acta Otolaryngol 49:206-212, 1958.Crossref 16. Heaney RP: Osteochondrodysplasia, in Cecil-Loeb Textbook of Medicine , ed 13. Philadelphia, WB Saunders Co, 1971, pp 1876-1877. 17. Jackson C, Jackson CL: Disease of the Nose, Throat, and Ear . Philadelphia, WB Saunders Co, 1959, pp 519. 18. McKusick JA: Heritable Disorders of Connective Tissue , ed 4. St. Louis, CV Mosby Co, chap 13 , 1972, pp 740-858. 19. Ash JE, Raum M: An Atlas of Otolaryngologic Pathology . Washington, DC, AFIP, pp 40, 1956.
Archives of Otolaryngology – American Medical Association
Published: Nov 1, 1974
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