Early diagnosis of tuberculous otitis media

In an area endemic for pulmonary tuberculosis, 23 of 192 histological specimens from chronic suppurative otitis media proved to be tuberculous. A personal or family history of tuberculosis was present in 75 per cent of the patients. A pre-operative diagnosis was made in six out of 23 patients, but middle ear mucosal biopsy and aural polypectomy provided a histological diagnosis in 30 and 35 per cent respectively. It is suggested that, when tuberculosis of the middle ear is a possibility, initial surgery for chronic suppurative otitis media should be minimal and directed towards obtaining a tissue diagnosis.