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Pathogenesis of middle-ear effusion in nasopharyngeal carcinoma: a new perspective

Published online by Cambridge University Press:  29 June 2007

W. K. Low ,
T. A. Lim ,
Y. F. Fan  and
A. Balakrishnan
W. K. Low*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Republic of Singapore.
T. A. Lim
Affiliation:
Department of Diagnostic Radiology, Singapore General Hospital, Republic of Singapore.
Y. F. Fan
Affiliation:
Department of Diagnostic Radiology, Singapore General Hospital, Republic of Singapore.
A. Balakrishnan
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Republic of Singapore.
*
Address for correspondence: Dr W. K. Low,Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore0316, Republic of Singapore. Fax: 65-2262079
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Abstract

The theory that middle-ear effusion (MEE) associated with nasopharyngeal carcinoma (NPC) is merely the result of tensor veli palatinus destruction is deficient because recent studies have shown that many patients with NPC have MEE but no tensor veli palatinus dysfunction. The present study evaluates the relationship between MEE and Eustachian cartilage erosion by NPC and examines the pathogenesis of NPC-associated MEE from a new perspective.

Thirty-five patients with NPC were studied by magnetic resonance scans taken along the lengths of the Eustachian tubes. Twenty-four patients had tumour involvementof both sides of the nasopharynx so that 59 ears were available for study. Eighteen ears had MEE of which 12 had Eustachian cartilage erosion (p<00001, Fischer's Exact Test). In ears with MEE, Eustachian cartilage erosion was frequently but not necessarily associated with tensor veli palatinus destruction.

We postulate that altered Eustachian tubal compliance as a result of cartilage erosion by tumour is an important reason why middle-eareffusions develop in patients with NPC.

Keywords

Eustachian tubeOtitis media with effusionNasopharyngeal neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 5 , May 1997 , pp. 431 - 434
Copyright
Copyright © JLO (1984) Limited 1997

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References

Bluestone, C. D. (1985) Current concepts in Eustachian tube function as related to otitis media. Auris-Nasus-Larynx (Tokyo) 12 (Suppl 1): 1–4.Google Scholar
Casselbrandt, M. L., Cantekin, E. I., Dirkmaat, D. C., Doyle, W. J., Bluestone, C. D. (1988) Experimental paralysis of tensor veli palatini muscle. Acta Otolaryngologica (Stockholm) 106: 178–185.Google Scholar
Falk, B. (1982) Sniff-induced negative middle ear pressure: study of a consecutive series of children with otitis media with effusion. American Journal of Otolaryngology 3: 155–162.CrossRefGoogle ScholarPubMed
Falk, B., Magnuson, B. (1983) Eustachian tube malfunction and middle ear disease in new perspective. Journal of Otolaryngology 12: 187–193.Google Scholar
Fry, H. (1967) Interlocked stresses in cartilage. Nature 215: 53–54.Google Scholar
Grontved, A., Moller, A., Jorgenson, L. (1990) Studies on gas tension in the normal middle ear. Acta Otolaryngologica (Stockholm) 109: 271–277.CrossRefGoogle ScholarPubMed
Hergils, L., Magnuson, B. (1990) Human ear gas compositionstudied by mass spectrometry. Acta Otolaryngologica (Stockholm) 110:92–99.Google Scholar
Low, W. K. (1995) Middle ear pressure in patients with nasopharyngeal carcinoma and their clinical significance. Journal of Laryngology and Otology 109: 390–393.Google Scholar
Low, W. K., Fong, K. W. (1996) Hearing disability before and after radiotherapy for nasopharyngeal carcinoma. Journal of Laryngology and Otology 110: 121–123.Google Scholar
Magnuson, B. (1981) On the origin of the high negative pressure inthe middle ear space. American Journal of Otolaryngology 2: 1–11.Google Scholar
Matsune, S., Sando, I., Takahashi, H. (1992) Elastin at the hinge portion of the Eustachian tube cartilage in specimens from normal subjects and those with cleft plate. Annals of Otology, Rhinology and Laryngology 101: 163–167.CrossRefGoogle Scholar
Murray, J. A. M. (1988) In Logan Turner's Diseases of the Nose, Throat and Ear. 10th Edition (Maran, A. G. D., ed.) Wright, London, pp 21–29.Google Scholar
Naito, Y., Hirono, Y., Honjo, I., Mori, C., Hoshino, K., Nishimura, K., Nakano, Y. (1987) Magnetic resonance imaging of the Eustachian tube. A correlative anatomical study. Archives of Otolaryngology, Head and Neck Surgery 113: 1281–1284.Google Scholar
Proud, G. O., Odoi, H., Toledo, P. S. (1971) Bullar pressure changes in Eustachian tube dysfunction. Annals of Otology, Rhinology and Laryngology 80: 835–837.Google Scholar
Sade, J. (1994) The nasopharynx, Eustachian tube and otitis media. Journal of Laryngology and Otology 108: 95–100.Google Scholar
Sade, J., Luntz, M. (1991) Gas diffusions in the middle ear. Acta Otolaryngologica (Stockholm) 111: 354–357.Google Scholar
Shibahara, Y., Sando, I. (1989) Congenital anomalies of the Eustachian tube in Down Syndrome. Histopathologic case report. Annals of Otology, Rhinology and Laryngology 98: 543–547.Google Scholar
Su, C. Y., Hsu, S. P., Lui, C. C. (1993) Computed tomography, magnetic resonance imaging and electromyographic studies of tensor veli palatmi muscles in patients with nasopharyngeal carcinoma. Laryngoscope 103: 673–678.CrossRefGoogle ScholarPubMed
Young, Y. H., Hsieh, T. (1992) Eustachian tube dysfunctionin patients with nasopharyngeal carcinoma, pre- and post-irradiation. European Archives of Otorhinolaryngology 249: 206–208.Google Scholar