High riding jugular bulb: Is it an etiological factor for benign paroxysmal positional vertigo?

Abstract

Introduction: High jugular bulb (HJB) is usually discovered incidentally; however, it may interfere with inner ear structures such as vestibular aqueduct (VA), facial nerve, and the posterior semicircular canal (PSCC). Objective: The aim is to investigate the incidence of HJB in benign paroxysmal positional vertigo patients with PSCC involvement (PSCC-BPPV). Materials and Methods: The study group included 53 consecutive, PSCC-BPPV patients, diagnosed in our clinic. Following the diagnosis, their high resolution computed temporal bone tomography were performed. The control group consisted of 90 patients, who attended to our clinic for various complaints, and to whom high resolution computed tomography of the temporal bone was conducted. Results: The incidence of HJB in the study group was 41.5% (n = 22). The incidence of ipsilateral HJB in this group was 28.3% (n = 15). The incidence of HJB in the control group was 11.1% (n = 10) (P < 0.001). The closest distance between HJB and PSCC canal in the control and study groups was 1.61 +/- 0.74 mm and 1.17 +/- 0.37 mm, respectively (P = 0.098). Conclusion: The HJB is significantly more frequent in PSCC-BPPV patients. Furthermore, the rate of incidence of HJB in the ipsilateral ears of these patients is significantly higher. Venous hypertension or the turbulence may cause strong pulsations, which influence the detachment of the otoconia into the PSCC.