Discussion Author: Steven J Goldstein
Dehiscent or High Riding Jugular bulb is an uncommon variant which may present as a retrotympanic middle ear mass. The sigmoid plate which normally lies between the middle ear cavity and jugular foramen is absent allowing the internal jugular vein to present in the hypotymanic portion of the middle ear cavity.
While usually asymptomatic the patient may present with hearing loss, tinnitus or pain. At otoscopy the high riding jugular bulb may appear to be a red mass which can simulate a glomus tumor or cholesteatoma.
Biopsy is contraindicated as it may result in severe hemorrhage.
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