Otitis Media With Effusion Caused by a Parapharyngeal Tumor Showing Normal Nasopharyngeal Findings

Abstract

The objective of this study is to evaluate otitis media with effusion (OME) among patients with parapharyngeal tumor. We have experienced 82 parapharyngeal tumor cases and encountered 14 patients complaining of hearing loss due to OME as the initial symptom. These patients showed normal nasopharyngeal findings and the presence of tumor had been detected long time after the beginning of their hearing symptoms (4 months to 13 years: median 2.5 years). Six patients had undergone ventilation tube insertion on the affected ear, which may lead to delay in diagnosis. Pathological examination was performed in 76 of 82 patients. Among these 76 patients, 13 showed OME. Seven patients had malignant lesions, whereas 6 had benign lesions. Therefore, malignant lesions are prone to occur with OME and its relative risk was 2.26 (95% confidence intervals, 1.16-4.42). This difference was statistically significant ( P = .044, Fisher test). Otitis media with effusion is a very common disease and is well-known as a primary symptom of nasopharyngeal carcinoma. Therefore, nasopharyngeal observation is necessary for patients with intractable middle ear effusion. However, present 14 patients with OME showed normal nasopharyngeal findings and finally found after an imaging study. From our data, OME is an important but go-by symptom of parapharyngeal tumors. Imaging studies are potently useful for such patients with intractable OME.

Reconstruction of the Obliterated Eustachian Tube: A Pilot Case Series

“…[6][7][8] Nasopharyngeal tumors and other extrinsic masses can cause obstruction and malignant neoplasms are significantly more likely to cause middle ear effusion, which is usually serous rather than mucoid. 4 Radiation therapy and surgical treatments adjacent to the ET may have a high incidence of otitis media with effusion (OME) post-treatment. 9,10 Granulomatous diseases such as sarcoidosis or Granulomatosis with Polyangiitis (GPA, aka.…”

“…1 Potential causes for total obliteration of the ET include trauma, surgery, and diseases affecting the nasopharyngeal orifice or cartilaginous portion of the ET. [2][3][4] Scarring from an adjacent procedure such as adenoidectomy can affect the ET orifice. 5 Aural symptoms, such as tinnitus, fullness, and otalgia, have been reported after orthognathic surgery typically lasting for 6-8 weeks possibly due to surgical edema.…”

“…Total obliteration of the Eustachian tube (ET) prevents its functions of pressure equalization and clearance of secretions, leading to chronic middle ear problems 1 . Potential causes for total obliteration of the ET include trauma, surgery, and diseases affecting the nasopharyngeal orifice or cartilaginous portion of the ET 2–4 …”

Endoscopy-Aided Combined Intraoral and Cervical Approach for a Huge Parapharyngeal Benign Tumor

“…In contrast, most benign lesions are asymptomatic. 5 Therefore, PS tumors sometimes grow huge in size in the PS. Especially, the key for the safe removal of pleomorphic adenomas is total removal without damage to its capsule, otherwise, local recurrence may occur.…”

“…Various tumors occur in the parapharyngeal space (PS) and show various symptoms. [1][2][3][4][5][6][7][8][9][10] However, the PS is located deep in the head, and a tumor in the PS is usually asymptomatic and may grow to a huge size. 11 In this article, we introduce our experience of the removal of a large PS tumor using a less invasive technique.…”