Persistent Foramen of Hushke is a very common embryological anomaly affecting 4.6% to 20% of population, but only a small fraction of patients is symptomatic.
We present a case of 56 year old gentleman diagnosed with nasopharyngeal carcinoma (NPC) in 2016 and completed CCRT treatment in the same year. On his routine follow-up, an otoendoscopy revealed bulging soft masses on the anterior walls of bilateral external auditory canal (EAC). The masses protruded when he opened his mouth and reduced when he closed it. This is due to the herniation of the temporomandibular joint content into the external ear canal which forms the posterior wall.
He denied any history of recurrent ear infection, ear discharge, reduced hearing, tinnitus, aural fullness or previous temporal bone trauma. He was treated conservatively.
Thus, it is prudent to consider persistent foramen of Hushke as a differential diagnosis when encountering anterior EAC mass.