Tuberculous Otitis Media: A Series of 22 Patients

Singhania

Indian J Otolaryngol Head Neck Surg

et al. 2013

Though tuberculosis (TB) primarily affects lungs, extra pulmonary tuberculosis (EPTB) is also common, especially in high disease load areas and mainly manifests in ENT region. To study the different manifestations of tuberculosis in ENT region in terms of presentation, disease process, treatment and outcome. Records of patients diagnosed and treated for TB in the ENT region at our institute's DOTS centre for a two and half year period were analysed for presenting complaints, examination findings, diagnostic features, treatment modes and outcome. Out of 3750 cases diagnosed as TB, 230 had EPTB. 211 cases had ENT manifestations. Majority of the cases were male and in the fourth decade of life. Commonest manifestation was cervical lymphadenopathy with 201 cases. Fine needle aspiration cytology was mostly diagnostic and category I anti TB treatment (AKT) achieved cure. The six cases of TB otitis media presented with ear discharge, sometimes bloody and had varied tympanic membrane findings and facial palsy in two cases with different types and degrees of hearing loss. Diagnosis was confirmed by histology of tissue removed during surgery. Patients completed category I AKT. Hearing and facial palsy did not improve. There were three cases of TB laryngitis and one of nasal TB both of which were confirmed by tissue diagnosis and responded well to AKT. Most of the results in the present study conform to findings of other studies. High degree of suspicion is necessary to reach diagnosis. Category I AKT is effective. Some cases may require surgery.

Section: Discussionsupporting

confidence: 69%

A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region

Singhania

Indian J Otolaryngol Head Neck Surg

et al. 2013

Indian J Otolaryngol Head Neck Surg

“…Mastoid X-rays usually show surprisingly little abnormality except for an increased density of the soft tissues in antrum [7]. Mastoid X-rays in our patient showed well pneumatized mastoid with no evidence of any haziness or destruction of mastoid air cells.…”

Section: Discussionsupporting

confidence: 41%

“…The pathogenesis of TOM involves three major mechanisms. The first mechanism is aspiration of mucus through the Eustachian tube, second is the blood borne dissemination from other tuberculous foci and third is direct implantation through the external auditory canal and a tympanic membrane perforation [7]. LV is a chronic, progressive and the commonest form of secondary cutaneous tuberculosis [8].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculous Otitis Media and Lupus Vulgaris of Face: An Unusual Association

Kohli

Kumar

Nibhoria

2011

Tuberculous otitis media is a rare extra-pulmonary presentation of tuberculosis. Tuberculous otitis media is usually associated with pulmonary tuberculosis or tuberculosis involving nasopharynx and oropharynx. Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis. The disease often affects the face and may be associated with nasal or nasopharyngeal tuberculosis. Lupus vulgaris associated with tuberculous otitis media is not reported in English literature. We report a case of 40 year old female patient who presented with symptoms of chronic suppurative otitis media and nonhealing skin lesion of face. The biopsy of skin lesion showed granulomatous pathology and helped us to reach a diagnosis of tuberculous otitis media.

J. Dhaka Natl. Med. Coll. Hosp.

“…Most patients also experience an associated acute-onset hearing loss that is disproportionate to the extent of the disease (13). Characteristically, there is little or no otalgia (14).The pathogenesis of tuberculous otitis media involves one of three major mechanisms: (1) aspiration of mucus through the eustachian tube, (2) blood-borne dissemination from other tuberculous foci, or (3) in rare cases, direct implantation through the external auditory canal and a tympanic membrane perforation (13).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous involvement of lungs, larynx and middle ear by tuberculosis -a rare case

Kabir

Shumon

Atikuzzaman

et al. 2012

SummarySimultaneous involvement of lungs, larynx and middle ear by tuberculosis is very rare. We present a rare case of simultaneous involvement of larynx and ear in a patient with pulmonary tuberculosis. A 17 years old male presented with fever and cough for 8 months, bilateral deafness for 5 months and hoarseness of voice for 3 months. The patient gave history of anorexia and progressive weight loss and history of close contact with tuberculosis patient. There were coarse crepitations on auscultation of both lungs. Indirect laryngoscopy revealed diffuse nodular swelling as well as thickening of the vocal cords. Examination of both ears revealed pale-yellow granulation tissue. ESR was 94 mm in 1 st hour and chest radiograph showed diffuse patchy opacities extending over both lung fields. The results of two sputum examinations showed numerous acid-fast bacilli Histopathologic examination of punch biopsy from right and left ear lesions and biopsy tissue from laryngeal lesion taken by endoscopic instrument revealed granulomatous inflammation histologically consistent with tuberculosis.The patient responded well and promptly to the antituberculous therapy. The aim of this article is to create an awareness of Ear Nose Throat tuberculosis and to consider tuberculosis in the differential diagnosis of ear and laryngeal diseases and to emphasize the need for prompt recognition and treatment.