Objectives: The aim of this study is to verify the critical role of adenoid hypertrophy and otitis media with effusion in adult patients in relation to diagnostic importance for patients with clinically asymptomatic nasopharyngeal carcinoma. Methods: One hundred and six adult patients met our criteria out of 256 cases underwent nasopharyngeal biopsy for the suspect of nasopharyngeal malignancy in our clinic between January 2009 and July 2014 were enrolled in this retrospective study. We divided

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... the patients into two groups according to patients with or without synchronous presence of otitis media with effusion in addition to adenoid hypertrophy. Results: Two patients out of 68 (2.9%) in the first (only adenoid hypertrophy) group and in one patient out of 38 (2.6%) in the second group had nasopharyngeal carcinoma. There was no statistically significant difference. Conclusion: We found that asymmetric adenoid hypertrophy in adult patients seems an important risk factor, and we strongly suggest that it needs biopsy for the suspect of nasopharyngeal carcinoma whether they synchronously have or not otitis media with effusion even though in the absence of other clinical symptoms to arouse suspicion about a nasopharyngeal malignancy such as neck mass, epistaxis, cranial nerve impairment.