A 40-year-old male presents with unilateral otalgia, sensation of aural fullness, and conductive hearing loss. On examination, the tympanic membrane is retracted with fluid level. Nasopharyngoscopy reveals a mass in the nasopharynx. Which Eustachian tube structure is most likely obstructed by the nasopharyngeal tumor, causing these symptoms?

• A Torus tubarius
• B Eustachian tube orifice (pharyngeal opening) ✓
• C Fossa of Rosenmüller
• D Levator veli palatini muscle

Explanation

The Eustachian tube pharyngeal opening lies in the lateral wall of the nasopharynx, posterior to the inferior turbinate. A nasopharyngeal mass compressing or obstructing this opening causes Eustachian tube dysfunction, leading to middle ear effusion, conductive hearing loss, and aural fullness. The fossa of Rosenmüller is the most common site of NPC origin but does not directly cause ear symptoms unless the Eustachian tube orifice is involved. The torus tubarius is the cartilaginous elevation of the Eustachian tube opening.

Reference: Diseases of Ear, Nose and Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.