Tympanogram of a 70 year old male with hearing loss and tinnitus revealed a type B wave. On examination he has a conductive type of deafness and a dull tympanic membrane on the right side. Lympadenopathy was present in the posterior triangle of neck. The most likely diagnosis is:
The presence of conductive type of hearing loss, dull tympanic membrane and type B tympanogram suggests the presence of middle ear cavity or serous otitis media. Serous otitis media in an older individual should raise the suspicion of nasopharyngeal malignancy. The presence of enlarged lymph nodes adds to the suspicion.
Middle ear tumor
Nasopharyngeal malignancy
Acoustic neuroma
T.B of middle ear