Jugular Bulb Diverticulum: A Rare Cause of Pulsatile Tinnitus and Literature Review

Abstract

Objectives: Pulsatile tinnitus involves a wide spectrum of etiologies. The etiologies include normal vascular variants, temporal bone tumor, acquired vascular lesions and chronic middle ear inflammatory diseases. Jugular bulb diverticulum is a rare cause of pulsatile tinnitus. We report one case of jugular diverticulum presenting with pulsatile tinnitus and its surgical management and outcome. Case Report: A 36-year-old woman with a history of uterine myoma and chronic anemia presented with right pulsatile tinnitus that was worsening in recent one month. Neurological exam was normal. ENT evaluation revealed no abnormalities via otoscopy and physical examination. The CT scan revealed right dominant jugular bulb with diverticulum projecting to posterior ear canal wall. We performed jugular bulb diverticulum resurfacing with temporalis fascia, Surgicel® and Gelfoam®, and bone wax via transmastoid approach. The symptom improved postoperative immediately. No major complications were noted during outpatient clinic follow-up. Conclusion: Transmastoid resurfacing of jugular bulb diverticulum is an effective management of pulsatile tinnitus from this kind vascular anomaly.