DOI: 10.36347/sjmcr.2019.v07i01.028

Pages: 93-98

Nasopharyngeal carcinoma is rare. Direct invasion of nasopharyngeal carcinoma to middle ear is very rare. Extension of nasopharyngeal carcinoma into middle ear, external auditory canal through eustachian tube is a rare method of spread. Spread is usually mucosal or submucosal along eustachian tube. Rarely, it can be locally advanced nasopharyngeal carcinoma invading eustachian tube and middle ear through extensive skull bone invasion. Presence of external auditory canal polyp or mass and presence of mastoid effusion on CT and MRI should warrant radiologist to look for presence of nasopharyngeal carcinoma. We report a case of nasopharyngeal carcinoma in an elderly female who first presented with auditory symptoms and presented with mass in external auditory canal with lower motor neuron facial nerve palsy. Both CT and MRI (plain and contrast) confirmed mass in nasopharynx, spread along eustachian tube with extension in middle ear cavity and external ear with mastoid effusion.