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. 2020 Sep;15(3):95-98.
doi: 10.1016/j.joto.2019.12.001. Epub 2019 Dec 16.

Tuberculous otitis media -series of 10 cases

Susan K Sebastian  1 , Aditya Singhal  1 , Ankur Sharma  1 , Pankajkumar Doloi  1
Affiliations

Tuberculous otitis media -series of 10 cases

Susan K Sebastian et al. J Otol. 2020 Sep.

Erratum in

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.

Keywords: Histopathological diagnosis; Mastoiditis; Otitis media; Tuberculosis.

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Figures

Fig. 1
Fig. 1
HRCT temporal bone, Axial cut-showing soft tissue density occupying the middle ear, mastoid cells And external canal with erosion of the mastoid cortex and sinus plate.
Fig. 2
Fig. 2
HRCT temporal bone Axial cut-howing soft tissue density occupying middle ear and mastoid cavity with bone destruction.
See this image and copyright information in PMC

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