A 45-year-old man presents with unilateral hearing loss, tinnitus, and a sensation of ear fullness. Examination reveals fluid in the middle ear. The most likely cause is:
- A Otosclerosis
- B Acute otitis media
- C Nasopharyngeal carcinoma causing eustachian tube obstruction ✓
- D Meniere's disease
Correct answer: C. Nasopharyngeal carcinoma causing eustachian tube obstruction
Explanation
Unilateral serous otitis media in an adult, especially with nasopharyngeal symptoms, should raise suspicion for nasopharyngeal carcinoma obstructing the eustachian tube. This is a classic presentation of NPC in endemic regions. Otosclerosis causes conductive hearing loss without middle ear fluid. Acute otitis media presents with ear pain and fever, not chronic unilateral hearing loss. Meniere's disease presents with episodic vertigo, not isolated hearing loss with middle ear effusion.
Reference: Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.