Presentation
The patient was sent for a CT to evaluate the nasopharynx and mild tinnitus.
Patient Data
The right jugular bulb appears markedly prominent with loss of sigmoid plate and impinging upon the right middle ear cavity, representing a dehiscent right jugular bulb, while the left jugular bulb is lesser in size, with partial loss of sigmoid plate and sticks on the middle ear cavity, also considering left jugular bulb dehiscence.
Coronal images demonstrate right and left jugular bulb dehiscence.
Case Discussion
A dehiscent jugular bulb is a common cause of pulsatile tinnitus and may present as a vascular mass behind the eardrum 1. It can also be an incidental finding in some cases.
Differential diagnoses to consider are 2:
high-riding jugular bulb with intact sigmoid plate
jugular paraganglioma/tympanicojugulare paragangliomas with adjacent destructive bone changes
Unfortunately, further clinical or imaging follow-up is not available for this case so whether these findings are a cause for tinnitus or an incidental finding is unknown.
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