OBJECTIVE: To describe case of bulb of dehiscent, unilateral high jugular vein in pediatrician patient with lip-palatal fiction ipsilateral transformed and to argue the pathophysiology of this alteration and possible clinical presentations. CASE REPORT: Feminine patient, 7 years, carrier of lip-palatal fiction complete transformed to the left, corrected. It was admitted in this service for accomplishment of secondary palatoplasty. In the operative evaluation daily pay, it presented to the otoscopy signals of bilateral secretory average otitis. It presented, in the aerial-osseous audiometry, gap of 40 dB bilaterally e, in the impedanciometry, curve type B bilaterally being indicated rank of pipe of bilateral ventilation. During the microscopy of left ear, complete and cloudy eardrum membrane was verified. After the accomplishment of the myringotomy in quadrant postero-inferior, the patient presented abundant bleed proceeding from average ear that was controlled with haemostasis with compressive Gelfoam. The too much procedures had been suspended and the patient was directed for accomplishment of computerized tomography of secular bones with contrast that demonstrated to bulb of the dehiscent vein left jugular vein in average ear. CONCLUSION: Dehiscent bulb of high jugular vein is a rare condition that it can be asymptomatic or to present specific symptoms to depend on its localization. The presence of other concomitant otologic disease can act as factor of confusion in the diagnosis due to overlapping of symptoms and alterations in the clinical examination. However, this diagnosis always must be considered front to the exploration of average ear in pediatrician patients, mainly in the presence of craniofacial bad-formations associates.