An enlarged bulb of the internal jugular vein at the jugular foramen can protrude into the middle ear or over the basal turn of the cochlea, and some symptoms of ear disease may occur. An unusual vascular abnormality, usually on the right temporal bone, and commonly asymptomatic. Positioning of a jugular bulb diverticulum can produce symptoms of conductive hearing loss, pulsatile tinnitus, and vertigo. Other signs and symptoms include sensorineural hearing loss, facial palsy, and headache. Diagnosis is made with MR angiography.

Management of symptomatic high jugular bulb includes observation or surgery, with favorable prognosis.