Reactive lymphoid hyperplasia of the eustachian tube orifice presenting with aural fullness: a case report

Reactive lymphoid hyperplasia (RLH) is a common benign lesion, yet its occurrence at the eustachian tube orifice-a rare skull base site-is poorly reported. Lesions in this anatomical region are predominantly malignant, predisposing clinicians to misdiagnose benign lesions as nasopharyngeal carcinoma and lead to overexamination and therapy. We herein report a 58-year-old male patient presenting with persistent aural fullness and hearing loss caused by a lymphoproliferative mass at the right eustachian tube orifice. A clinical timeline is provided to clarify the disease course. The clinical characteristics, imaging features, endoscopic findings, surgical management, and pathological diagnosis are discussed. This case provides practical insights for the diagnosis and treatment of similar rare lesions, helping to reduce misdiagnosis and overtreatment.