The 'blue drum' sign (blue or brownish discolouration of the tympanic membrane) in the posterior superior quadrant is characteristic of:
- A Glomus tympanicum tumor
- B Cholesteatoma of the posterior superior quadrant
- C High jugular bulb or aberrant jugular vein ✓
- D Hemotympanum following trauma
Correct answer: C. High jugular bulb or aberrant jugular vein
Explanation
A 'blue' or bluish-purple tympanic membrane in the posterior inferior quadrant or posterior superior quadrant may indicate a high riding jugular bulb or dehiscent/aberrant internal jugular vein bulging into the middle ear. This is a vascular anomaly that must not be mistaken for a middle ear effusion or biopsied/incised. Hemotympanum is blood-red/dark after trauma. Glomus tympanicum appears as a reddish-pink 'rising sun' pulsatile mass behind the tympanic membrane.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.