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Case Reports
. 2021 Apr 12;14(4):e241591.
doi: 10.1136/bcr-2021-241591.

Dual retrotympanic aural mass

Nurul Asma Che Ab Rahim  1 , Jeyasakthy Saniasiaya  2 , Jeyanthi Kulasegarah  1
Affiliations
Case Reports

Dual retrotympanic aural mass

Nurul Asma Che Ab Rahim et al. BMJ Case Rep. .

Abstract

High-riding jugular bulb (HRJB), although rare, may pose a challenge as it may be mistaken for other non-alarming condition, such as middle ear effusion. Patients with HRJB classically present with pulsatile tinnitus. We report a unique case of a 26-year-old patient with underlying beta thalassaemia who presented with a 2-month history of intermittent epistaxis and rhinorrhoea. Otoscopic examinations revealed a pulsatile bluish mass behind the right tympanic membrane and a dull left tympanic membrane. Imaging performed revealed a finding of dual retrotympanic pathology, which consisted of a right dehiscent HRJB and left cholesterol granuloma. We highlight a rare case of dual retrotympanic mass as well as its management.

Keywords: ear; nose and throat/otolaryngology; radiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Right otoscopic image showing red-bluish retrotympanic mass occupying the posterior inferior quadrant of the tympanic membrane with some tympanosclerosis.
Figure 2
Figure 2
Otoscopic image of the left ear showing a dull tympanic membrane.
Figure 3
Figure 3
Pure tone audiogram of the right ear showed 10–20 dB conductive hearing loss.
Figure 4
Figure 4
High-resolution CT denotes high, dehiscent right jugular bulb projecting into the right middle ear cavity. Black arrowhead signify Right jugular bulb.
Figure 5
Figure 5
MRI denotes hyperintensity in the T1-weighted soft tissue lesion in the left mastoid and hypotympanum. Black arrowhead signify Left cholesterol granuloma.
See this image and copyright information in PMC

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