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Case Report Volume 17 Issue 3
The surgical challenge of high-riding jugular bulb in otologic surgery: a case-based experience for otologic surgeons
Madhuri Kaintura, Mridul Pandey, Apoorva Kumar Pandey
Received: August 18, 2025 | Published: October 21, 2025
Citation: Pandey AK. The surgical challenge of high-riding jugular bulb in otologic surgery: a case-based experience for otologic surgeons.J Otolaryngol ENT Res. 2025;17(2):81‒83. DOI: 10.15406/joentr.2025.17.00573
Abstract
A high-riding jugular bulb (HRJB) is a vascular anatomical variant wherein the dome of the jugular bulb extends superiorly into the middle ear cavity or toward the internal auditory canal. This is mostly asymptomatic, but it can pose significant surgical challenges when encountered unexpectedly during middle ear surgeries. Here, we report 2 cases: one with COM who underwent tympanoplasty, wherein bilateral high-riding jugular bulbs were noted (diagnosed intraoperatively in the to-be-operated ear), and the second where there was huge intraoperative bleeding due to a dehiscent jugular bulb. This article highlights the importance of thorough preoperative radiological assessment and intraoperative vigilance, especially in resource-limited settings where high-resolution imaging may not always be feasible.
Keywords: high-riding jugular bulb (HRJB), tympanoplasty, computed tomography, Hemorrhage, chronic otitis media (COM), modified radical mastoidectomy (MRM)
©2025 Pandey, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.