The jugular bulb in otologic surgery: anatomic, clinical, and surgical considerations.

The jugular bulb varies widely in position and dimensions. In certain pathologic conditions there is an increased incidence of jugular bulb enlargement, but such enlargement also occurs without an obvious underlying cause. Jugular bulb enlargment may lead to clinical symptoms for the patient and particular difficulties for the otologic surgeon, not only in the middle ear but also in neurotologic approaches. The different clinical aspects and problems associated with jugular bulb enlargement are discussed with illustrative cases and temporal bone histologic findings.