Dehiscence of the jugular bulb in crouzon's disease

Patients with Crouzon's disease have a distorted nasopharynx, which frequently leads to retained middle ear secretions and necessitates myringotomy. A review of the computed tomographic (CT) scans of 21 ears in 11 patients with Crouzon's disease found that 12 jugular bulbs were protruding or dehiscent. The relationship between the jugular bulb and the middle ear space was normal bilaterally in only 2 of the 11 patients. Consequently, patients with Crouzon's disease are at risk for inadvertent puncture of the jugular bulb during myringotomy. CT scans obtained prior to myringotomy can be helpful in detecting dehiscent or protruding jugular bulbs.