Correlation of Pre-Therapeutic Tympanogram Findings with Primary Tumor Anatomical Localization and T-Category in Patients with Nasopharyngeal Carcinoma: A Cross-Sectional Diagnostic Study at a Tertiary Referral Center in Bali, Indonesia
DOI:
https://doi.org/10.37275/oaijmr.v6i5.940Keywords:
Eustachian tube dysfunction, Fossa of Rosenmüller, Nasopharyngeal carcinoma, Otitis media with effusion, TympanometryAbstract
Background: Nasopharyngeal carcinoma arises in the fossa of Rosenmüller beside the Eustachian tube orifice and may cause middle-ear dysfunction. Whether tympanometry reflects tumor localization or the AJCC/UICC T-category remains uncertain.
Objective: To determine the correlations of pre-therapeutic tympanogram findings with primary tumor anatomical localization and T-category in patients with nasopharyngeal carcinoma.
Methods: This prospective-designed cross-sectional study included 43 consecutive, histopathologically confirmed patients evaluated before treatment at Prof. dr. I.G.N.G. Ngoerah General Hospital, Bali, from January to June 2026. Assessments comprised bilateral 226-Hz tympanometry, flexible video-nasopharyngoscopy, and contrast-enhanced head and neck computed tomography. Tumor extension was classified by mucosal topography and AJCC/UICC eighth-edition T-category. Spearman rank correlation and multivariable logistic regression were used.
Result: Participants were mostly male (29/43, 67.4%); median age was 52 years. T4 disease occurred in 23 patients (53.5%), T2 in 12 (27.9%), and T3 in eight (18.6%). The fossa of Rosenmüller was involved in all patients; 26 (60.5%) had bilateral extension, seven (16.3%) unilateral extension, and 10 (23.3%) circumferential or complete tubal-ostial enclosure. Type B tympanograms occurred in 30 patients (69.8%) and Type C in 13 (30.2%); no Type A curves occurred. Tympanogram profile correlated strongly with anatomical localization (rs = 0.745, 95% CI 0.572–0.854; p < 0.001; adjusted OR 18.52, 95% CI 2.82–121.40; p = 0.002) but not with T-category (rs = 0.051; p = 0.697).
Conclusion: Pre-therapeutic middle-ear dysfunction in nasopharyngeal carcinoma tracks tumor extension toward the Eustachian tube rather than T-category. Baseline tympanometry can complement anatomical assessment and identify patients who may benefit from timely otologic evaluation before chemoradiotherapy.
Authors
- I Ketut Suanda1
- I Gede Wahyu Adi Raditya2*
- I Putu Yupindra Pradiptha2
- 1Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Medicine, Universitas Udayana / Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Indonesia
- 2Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Medicine, Universitas Udayana / Udayana University Hospital, Badung, Indonesia
Corresponding author I Gede Wahyu Adi Raditya — dr.gedewahyu@unud.ac.id
Downloads
Published
Issue
Section
License
Copyright (c) 2026 I Ketut Suanda, I Gede Wahyu Adi Raditya, I Putu Yupindra Pradiptha
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright in their articles and grant Open Access Indonesian Journal of Medical Reviews (OAIJMR) the non-exclusive right of first publication. Unless otherwise stated on an individual article, published work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). Users may share and adapt the work for non-commercial purposes provided that appropriate attribution is given, changes are indicated, and adaptations are distributed under the same license. Copyright in the journal website, logo, layout, and other publisher-owned materials is separate from copyright in individual articles.
How to Cite
Article Metrics
Views and downloads recorded by this journal.
