A case of a 63 year-old woman with acute vertigo, hearing loss and tinnitus caused by a nasopharyngeal carcinoma is reported. Despite a long-standing unilateral Eustachian tube dysfunction, only the occurrence of vertigo attacks lead to the diagnosis in this patient. Inner ear-related symptoms are rare in nasopharyngeal carcinoma and the disease is uncommon in Europe. Skull base tumors are an important differential diagnosis of labyrinth dysfunction that can be detected by MRI. A complete diagnostic work-up is necessary in patients with unilateral tube dysfunction, to allow early detection of this disorder.
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