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Anatomically, the top portion of the jugular bulb lies just below the floor of the hypotympanum. In rare instances, it can protrude upward and elevate the floor of the hypotympanum thus placing it in the middle ear. Such a case is called high jugular bulb.

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An ectopic muscle was found in the hypotympanum of a 31-year-old Japanese male. The muscle produced symptoms quite similar to those seen in cases of glomus jugulare tumor: a red mass visible through the ear drum, conductive deafness, a compressed jugular bulb demonstrable by retrograde jugulography, and VIIth and IXth nerve paresis. However, the audible pulsating tinnitus of glomus jugulare tumor was absent.

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Tumours of the glomus jugulare always raise diagnostic and therapeutic problems. We decided to review the pathology and clinical findings whilst reporting a typical case found on our neurology unit. After a brief review of the embryology, anatomy and histology of the glomus jugulare, the authors report the case of a patient who presented a recurrent intracranial form with involvement of several cranial nerves, together with associated involvement of the carotid glomus.

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