Head and Neck Imaging

Jugular bulb, protruding

jugular bulb protruding into the middle ear through a congenital defect of the jugular plate. Otoscopically, a retrotympanic vascular mass is seen in the lower part of the middle ear. This is usually asymptomatic, but may cause tinnitus or conductive hearing loss. CT shows a soft tissue mass low in the middle ear, contiguous with the internal jugular vein through the jugular plate defect (Fig.1). The other margins of the jugular foramen are smooth and intact, differentiating this condition from a jugulotympanic glomus tumour.

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Fig.1

Axial (a) and coronal (b) CT image shows on the left a wide jugular bulb, protruding into the middle ear through a focal jugular plate defect (arrow).
Jugular bulb, protruding, Fig.1 (a)
Jugular bulb, protruding, Fig.1 (b)