Extension of nasopharyngeal carcinoma and otitis media with effusion

In 35 patients with nasopharyngeal carcinoma that occupied the fossa of Rosenmüller, the relationship of the tumor, assessed by computed tomographic scans, to otitis media with effusion and ventilatory function of the eustachian tube was examined. Incidence of otitis media with effusion was low when the tumor was limited to the fossa of Rosenmüller (stage I), and high when the tumor extended from the fossa to the parapharyngeal space (stage II). Passive opening of the eustachian tube remained normal until the tumor occupied the parapharyngeal space (stage III). However, active tubal opening was impaired in stage I and the impairment increased with the tumor stage. These results indicate that tumor extension from the fossa of Rosenmüller to the parapharyngeal space and resultant poor active tubal opening cause the development of otitis media with effusion in patients with nasopharyngeal carcinoma.