PATHOGENESIS OF MIDDLE-EAR EFFUSION IN NASOPHARYNGEAL CARCINOMA - A NEW PERSPECTIVE

The theory that middle-ear effusion (MEE) associated with nasopharynge al carcinoma (NPC) is merely the result of tensor veli palatinus destr uction is deficient because recent studies have shown that many patien ts with NPC have MEE but no tensor veli palatinus dysfunction. The pre sent study evaluates the relationship between MEE and Eustachian carti lage erosion by NPC and examines the pathogenesis of NPC-associated ME E from a new perspective. Thirty-five patients with NPC were studied b y magnetic resonance scans taken along the lengths of the Eustachian t ubes. Twenty-four patients had tumour involvement of both sides of the nasopharynx so that 59 ears were available for study. Eighteen ears h ad MEE of which 12 had Eustachian cartilage erosion (p < 0.00001, Fisc her's Exact Test). In ears with MEE, Eustachian cartilage erosion was frequently but not necessarily associated with tensor veli palatinus d estruction. We postulate that altered Eustachian tubal compliance as a result of cartilage erasion by tumour is an important reason why midd le-ear effusions develop in patients with NPC.