Exposed superior bulb of the internal jugular vein. Differential hearing loss diagnosis with pulse synchronous tinnitus

A case report is presented of a 54-year-old woman with tinnitus synchronous with her pulse and an ipsilateral conductive hearing loss. Otoscopy showed a pulsatile structure behind the right eardrum. Imaging with high-resolution computed tomography of the temporal bone showed an enlarged jugular vein bulb. Magnetic resonance imaging could not be performed because of an implanted pacemaker. Since a glomus jugulare tumor could not be excluded right diagnostic tympanoscopy was performed and revealed a high jugular bulb that filled nearly a third of the tympanum.