Middle ear extension of nasopharyngeal carcinoma via eustachian tube. A temporal bone report.

The eustachian tube is a pathway used for nasopharyngeal metastases to the temporal bone, but not as frequently as hematogenous and direct methods of spread. A patient with conductive hearing loss was found to have nasopharyngeal carcinoma extending up the right eustachian tube into the middle ear space on examination of the temporal bone. Submucosal invasion of the eustachian tube with bony destruction of the wall resulting in the development of organizing inflammatory exudate in the middle ear were demonstrated.