Nasopharyngeal Carcinoma and Type B Tympanogram

Nasopharyngeal carcinoma (NPC)

Nasopharyngeal carcinoma (NPC) is a type of cancer that originates in the nasopharynx, which is the upper part of the throat behind the nose. One of the common audiological findings in NPC is a Type B tympanogram.

What is a Type B Tympanogram?

A Type B tympanogram is a flat tympanogram that indicates a non-compliant middle ear system. This means that the eardrum and middle ear bones are not moving normally in response to sound or air pressure.

Association with Nasopharyngeal Carcinoma

NPC can cause a Type B tympanogram in several ways

Eustachian tube obstruction

The Eustachian tube connects the middle ear to the back of the throat. NPC can block this tube, leading to a buildup of fluid in the middle ear and a resulting Type B tympanogram.
Middle ear effusion

NPC can cause inflammation and fluid buildup in the middle ear, resulting in a Type B tympanogram.
Tumor invasion

In advanced cases, NPC can invade the middle ear and cause damage to the eardrum and middle ear bones, leading to a Type B tympanogram.

Clinical Implications

A Type B tympanogram in a patient with NPC may indicate:

Middle ear involvement

The presence of a Type B tympanogram may suggest that the NPC has spread to the middle ear.
Need for further evaluation

A Type B tympanogram may prompt further evaluation, such as imaging studies (e.g., CT or MRI) to assess the extent of the tumor.
Impact on treatment planning

The presence of a Type B tympanogram may influence treatment planning, such as the need for radiation therapy or surgery to address the middle ear involvement.

In summary, a Type B tympanogram is a common audiological finding in NPC, and it may indicate middle ear involvement, the need for further evaluation, Type B tympanogram is a flat tympanogram that indicates a non-compliant middle ear system, impacted foreign bodies in the external auditory canal or a defect in tympanic membrane.

Other Situations That Give Rise To Type B Tympanograms

Middle ear effusion (MEE): The presence of fluid in the middle ear, which can be caused by a cold, allergies, or an ear infection.
Otitis media with effusion (OME): A condition where the middle ear is filled with fluid, often causing hearing loss and a feeling of fullness in the ear.
Tympanic membrane perforation: A hole or tear in the eardrum, which can cause a flat tympanogram.
Middle Ear tumors: Rarely, a Type B tympanogram can be caused by a tumor in the middle ear, such as a glomus tumor.
Eustachian tube dysfunction: Dysfunction of the Eustachian tube, which connects the middle ear to the back of the throat, can also cause a Type B tympanogram.
Grommet or ventilation tube insitu in the middle ear.
Foreign body in the external auditory meatus such as bead, eraser, groundnuts seed, corn seed, button, button battery, toy parts etc.
Impacted wax or cerumen in the external auditory canal.

In a Type B Tympanogram, the tympanometer is unable to detect a clear peak in the compliance curve, indicating a non-compliant middle ear system.

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