{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:34:34Z","timestamp":1781714074575,"version":"3.54.5"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Wave I<jats:sub>n<\/jats:sub>, which refers to the negativity between waves I and II in auditory brainstem response (ABR), is an electrophysiological phenomenon observed in previous studies. The term \u201chigh jugular bulb\u201d (HJB) describes a jugular bulb that is located in a high position in the posterior aspect of the internal acoustic canal. The present study aimed to explore the correlation between wave I<jats:sub>n<\/jats:sub> and the possibility of a HJB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included a cohort of pediatric patients diagnosed with profound hearing loss who were enrolled in a government-sponsored cochlear implantation program at an academic medical center between January 2019 and December 2022. The analysis involved examining the results obtained from the ABR test and high-resolution computed tomography (HRCT) of the temporal bone in the patients. The position of the jugular bulb was classified according to the Manjila and Semaan classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 221 pediatric patients were included in the study. Twenty-four patients, with a median age of 3 years and a range of 1\u20137 years, showed significant bilateral (<jats:italic>n<\/jats:italic>\u2009=\u200921) or unilateral (<jats:italic>n<\/jats:italic>\u2009=\u20093) wave I<jats:sub>n<\/jats:sub> (mean latency: right ear, 2.16\u2005ms\u2009\u00b1\u20090.22\u2005ms; left ear, 2.20\u2005ms\u2009\u00b1\u20090.22\u2005ms). The remaining 197 patients showed an absence of ABR. The HRCT images revealed that 18 of the 24 patients (75%) had HJB, but only 41 of the 197 patients who lacked ABR (20.8%) showed signs of HJB. The ratio difference was considered statistically significant based on the chi-squared test (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200932.10, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). More than 50% of the HJBs were categorized as type 4 jugular bulbs, which are located above the inferior margin of the internal auditory canal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ABR wave I<jats:sub>n<\/jats:sub> in pediatric patients with profound hearing loss suggests a high possibility of HJB. The physiological mechanism underlying this correlation needs further investigation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1183388","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T16:00:33Z","timestamp":1699286433000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Wave In in auditory brainstem response suggests a high possibility of a high jugular 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