Tuberculous otitis media –series of 10 cases

Abstract

Background Tuberculosis (TB) of the middle ear cleft (MEC) is a rare extra-pulmonary manifestation. Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult. Objectives To study the clinical presentations, complications and effective diagnostic modalities in tuberculosis of middle ear cleft. Methods We retrospectively studied 10 patients diagnosed with chronic otitis media, unresponsive to 2 months conventional treatment. Pure tone audiogram, High resolution computed tomography (HRCT) of temporal bone, and AFB staining of ear discharge were done. All patients underwent mastoid surgery. AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done. Results Clinical findings were mastoid swelling, facial palsy and post-aural fistula 3,4 & 2 patients respectively. All patients had persistent ear discharge and three had vertigo. Hearing loss was of moderate conductive type in five, sensorineural type in three and mixed type in two. HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases. Diagnosis of TB was confirmed either by (a) demonstration of AFB in ear discharge (4 patients)/tissue removed during surgery (4 patients) or (b) by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC (8 patients). Conclusion Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas. Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.

Unusual presentation of tubercular mastoid cyst

“… 7 However, most cases present with non-specific clinical features making it a diagnostic challenge. 8 In the present case, we report an atypical presentation of TOM which presented with chronic ear discharge along with the bony mastoid cyst. No literature has reported TOM presented as a mastoid cyst and to the best of our literature review, this would be the first case report.…”

Canal wall down in tuberculosis matoiditis: 4 case series

“…Primary tuberculosis of the ear is rarely reported, and the disease is usually secondary to infection of the lungs, larynx, pharynx and nose. TB bacteria can enter the temporal bone by a variety of routes: insufflation through the eustachian tube, hematogenous spread, contact from adjacent intracranial or extracranial infected foci, directly through the external acoustic canal through perforation of the tympanic membrane [ 10 ].…”

Semiologia Otorrinolaringológica

“…Existe um quadro clássico de múltiplas perfurações na membrana timpânica, mas ele é efêmero e difícil de ser visualizado. Nessa fase é frequente também o aparecimento de múltiplos pólipos que sangram no conduto auditivo (ABES; ABES; JAMIR, ARAÚJO et al, 2011;RODRIGUES et al, 2013;SEBASTIAN et al, 2019;SENS et al, 2008).…”