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

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.