Encountering a high jugular bulb during ear surgery

Encounters with jugular bulb abnormalities during ear surgery are a rare but recognised problem. A high riding jugular bulb is present in 10%–15% of patients and its variable position within the temporal bone can lead to problems as brisk venous haemorrhage can result if the bulb is inadvertently opened. The case of a 52-year-old woman with a central tympanic membrane perforation who underwent elective endaural myringoplasty and experienced brisk bleeding on raising the tympanomeatal flap is presented.