Cause of unilateral secretory otitis media in an adult is
Benign and malignant tumours of nasopharynx should always be excluded in unilateral serous otitis media in an adult. Nasopharyngeal carcinoma Clinical features Nasal: Nasal obstruction, nasal discharge, denasal speech and epistaxis. Otalgic: Due to obstruction of the eustachian tube, there is a conductive type of hearing loss, serous or suppoive otitis media. Tinnitus and dizziness may occur. Presence of unilateral serous otitis media in an adult should raise suspicion of nasopharyngeal growth. Ophthalmoneurologic: Squint and Diplopia(CN 6), Ophthalmoplegia( CN 3,4 and 6) facial pain and reduction of corneal reflex(CN 5), exophthalmos and blindness(CN 2).Involvement of CN 9,10,11 may occur constituting jugular foramen syndrome. Involvement of the cervical sympathetic chain causes horner's syndrome. Cervical nodal metastasis. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 284,285)
CSOM
Nasopharyngeal carcinoma
Mastoiditis
Foreign body of external ear
Ear