Unilateral middle ear serous effusion in an adult, most common cause ?

Ans. is 'c' i.e., Nasopharyngeal carcinoma "In adults presenting with a unilateral middle ear effusion the possibility of a nasopharyngeal carcinoma should be considered-- Current otolaryngology 2"d/e p. 659 "A high incidence of NPC (Nasopharyngeal carcinoma) in South East Asia and Southern China correlates with the high incidence of OME (otitis Media with Effusion) in adults in these regions". - Scott Brown 7"d/e Vol III p. 3389