42-year-old man with tinnitus

 

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Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

 

Case Section

Head & Neck Imaging

 

Patient's Information

Gender : Male
Age : 42

 

Clinical Summary

42-year-old man with tinnitus

 

Imaging Findings

In axial T2-weighted spin-echo images,an area of signal void in posterior aspect of the left internal acoustic meatus is seen which in correlation with post-gad images, there is a tubular enhancing structure in continuity with internal jugular vein .In coronal plane image,extension of the dome of the internal jugular vein above the floor of the internal acoustic canal is clearly depicted.

 

Differential Diagnosis

1.High jugular bulb,2.Asymmetric large jugular bulb,3.Dehiscent jugular bulb

 

Final Diagnosis

High jugular bulb as normal variant

 

Discussion (Related Text)

A high riding jugular bulb is distinguished from an asymmetrically large jugular bulb by its dome reaching above the internal acoustic meatus (IAM). It need not be larger than the contralateral bulb, but usually is. A run of the mill high riding jugular bulb has an intact sigmoid plate (a thin plate of bone separating the jugular bulb from the middle ear cavity). This can only be appreciated on thin slice bone algorithm CT, and is too thin to appreciate on MRI. If the sigmoid plate is deficient, the the bulb is free to protrude into the middle ear cavity, and is then known as a dehiscent jugular bulb and is a common cause of a retrotympanic vascular mass.

 

References

JD Swatrz, HR Harnsberger "Imaging of the Temporal Bone" Thieme

 

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