Nasopharyngeal oncocytic lesions are a spectrum of benign lesions that represent a reactive or hyperplastic response to chronic inflammation such as smoking and age-related degeneration. The lesions differ based on location, origin, and presence of cystic and inflammatory components. While these oncocytic lesions are frequently asymptomatic, larger lesions in the nasopharynx can result in significant symptoms such as eustachian tube dysfunction.