THE NASOPHARYNX, EUSTACHIAN-TUBE AND OTITIS-MEDIA

It has been classically hypothesized that a mass in the nasopharynx ca uses an obstacle to air flow through the eustachian tube, thereby crea ting a negative pressure in the middle ear followed by an effusion. Ho wever, examination of the relevant data concerning the supposed obstru ction of the eustachian tube by nasopharyngeal carcinomas, choanal pol yps and adenoids does not seem to support this cause and effect relati onship. Evidence points to other more sophisticated mechanisms which c ause negative pressure and an effusion in pathological middle ear cond itions. While the hypothesis of a nasopharyngeal mass as the usual obs tructive cause of middle ear effusion is hard to maintain, evidence do es exist to support the origin of middle ear infection, as seen in acu te and secretory otitis media, as being associated, at times, with an ascending infection from the nasopharynx.