Korean J Otolaryngol-Head Neck Surg.  1999 Aug;42(8):973-980.

A Clinical, Radiologic Study of Tuberculous Otitis Media

Affiliations
  • 1Department of Otolaryngology, Masan Samsung Hospital, College of Medicine, Sungkyunkwan University, Masan, Korea. entpark@netian.com

Abstract

BACKGROUND AND OBJECTIVES: Tuberculous otitis media is not commonly found nowadays, and therefore, the index of suspicion is often low. However, once contracted, it can cause significant morbidities, such as profound hearing loss, labyrinthitis, facial nerve palsy and so on, if early diagnosis and treatment are not performed.
MATERIALS AND METHODS
In the chronic otitis media patients who visited Masan Samsung Hospital from Jan. 1993 to Jan. 1996, 37 cases of pathologically proven tuberculous otitis media were retrospectively reviewed. And temporal bone computerized tomography (TBCT) of 14 cases of tuberculous otitis media were compared to those of chronic suppurative otitis media and choronic otitis media with cholesteatoma.
RESULTS
1) Classic clinical findings of the disease such as multiple perforation, painless otorrhea, young age are not consistent with the clinical findings reviewed here. 2) Unexpectedly severe hearing loss, facial paralysis, eroded malleus handle, polypoid granulation or necrotic debris in middle ear cavity were significant clinical features. 3) In TBCT findings, soft tissue density in the entire middle ear cavity, soft tissue density extension to superior external auditory canal, poor sclerotic change of mastoid air cell were more common than other types of chronic otitis media. 4) Most of cases were confirmed by operative specimen pathologically. 5) Delayed healing of postoperative wound and formation of granulation tissue suggested tuberculous otitis media. 6) Antituberculous chemotherapy provided effective means of treatment.
CONCLUSION
Early diagnosis by pathologic examination of biopsied tissue obtained at OPD was mandatory to avoid complication and postoperative morbidity. Postoperative specimen obtained from middle ear surgery must be confirmed pathologically.

Keyword

Tuberculous otitis media; Temporal bone computerized tomography

MeSH Terms

Cholesteatoma
Cytochrome P-450 CYP1A1
Drug Therapy
Ear Canal
Ear, Inner
Ear, Middle
Early Diagnosis
Facial Nerve
Facial Paralysis
Granulation Tissue
Hearing Loss
Humans
Labyrinthitis
Malleus
Mastoid
Otitis Media*
Otitis Media, Suppurative
Otitis*
Paralysis
Retrospective Studies
Temporal Bone
Wounds and Injuries
Cytochrome P-450 CYP1A1
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