A high-riding jugular bulb is defined by the superior aspect of the jugular bulb being present above the level of the inferior aspect of the internal auditory canal. Though typically asymptomatic, patients with high-riding jugular bulb may report several otologic and vestibular symptoms, most often conductive hearing loss, pulsatile tinnitus, and vertigo....
Clinicians should include an extremely high-riding jugular bulb in the differential diagnosis when a retrotympanic (behind the eardrum) mass presents with conductive hearing loss, to avoid dangerous surgical misadventure; no change to routine audiological protocol is indicated.
Misidentifying a vascular anomaly as a soft-tissue mass can lead to life-threatening intraoperative hemorrhage, making awareness of this presentation critical for ENT and audiology teams.
- 01Extremely high-riding jugular bulb can mimic a retrotympanic mass on otoscopy.
- 02Presented with conductive hearing loss, a finding that could mislead toward surgical biopsy.
- 03Imaging is essential before any surgical intervention on posterior tympanic membrane masses.
- 04Case highlights a rare but potentially dangerous diagnostic pitfall.
- 05Published in ENT Journal as a single case report.
An extremely high-riding jugular bulb can present as a mass posterior to the tympanic membrane with associated conductive hearing loss.
studysupported- PMID
- 42427291
- DOI
- 10.1177/01455613261463569.
- Journal
- ENT Journal
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient presenting with retrotympanic mass and conductive hearing loss
- Intervention
- Diagnostic evaluation of retrotympanic mass
Primary outcomes
Identification of jugular bulb anomaly; Characterisation of associated conductive hearing loss