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Tuberculous otitis: an underdiagnosed disease
1Ear, Nose, and Throat Department, Cecilia Makiwane Hospital, Mdantsane, Ciskei, Republic of South Africa.
Abstract:
A series of 31 cases (33 ears) of tuberculous otitis was reviewed. Classical findings of the disease, such as painless ottorhea and multiple perforations of the tympanic membrane, are not consistent with the clinical findings reported here. Severe conductive hearing loss, abundant pale granulations, and an eroded malleus handle occur consistently and appear to be important clinical features of the disease. In all cases suspected of tuberculosis, granulation tissue from the middle ear or mastoid was submitted for bacteriologic and histologic examination. As a result, tuberculous otitis was diagnosed in its early stages. In 10 patients (32%), pulmonary tuberculosis was found following confirmation of the tuberculous otitis media. Following 6 months of treatment with oral antituberculous therapy in conjunction with surgery, no evidence of active tuberculosis was present in any of the patients studied.
Insights
Tuberculous otitis often presents with severe hearing loss and ear granulations, differing from classical symptoms. Early diagnosis and treatment with antituberculous therapy and surgery are effective.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Tuberculous otitis media is a rare manifestation of extrapulmonary tuberculosis.
- Classical clinical findings may not always be present, leading to diagnostic challenges.
Purpose of the Study:
- To review cases of tuberculous otitis media and identify consistent clinical features.
- To evaluate the effectiveness of early diagnosis and treatment.
Main Methods:
- Retrospective review of 31 cases (33 ears) of tuberculous otitis.
- Bacteriologic and histologic examination of granulation tissue.
- Correlation with pulmonary tuberculosis findings.
Main Results:
- Severe conductive hearing loss, pale granulations, and eroded malleus handle were consistent findings.
- Early diagnosis was achieved through tissue examination.
- Pulmonary tuberculosis was identified in 32% of patients.
- 6 months of treatment led to no evidence of active disease.
Conclusions:
- Severe conductive hearing loss and specific middle ear findings are key indicators of tuberculous otitis.
- Early diagnosis and combined therapy are crucial for successful management.
- Tuberculous otitis media can be an early sign of pulmonary tuberculosis.