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[Clinical observations of tuberculous infection of the middle ear]
Abstract:
Since fifty years, three main infection routes of otitis media tuberculosa have been advocated by the literature. In childhood it was considered to be limited to haematogenic or primary infection, because the tuberculous focus was not found in the lung or in other parts of the body. Two own observations of children with tuberculosis of the middle ear were reported by the authors. Histological examination of the granulation tissue, taken from the mastoid cavities, showed Langhans cells. Also tuberculosis was verified by microbiological examination. When adenotomy was performed one month after the ear operation, also the adenoid tissues showed typical tuberculosis. The authors suggest the possibility of tubal infections from the adenoid tissue into the middle ear.
Insights
Tuberculosis of the middle ear in children may result from tubal infection originating in the adenoids. This challenges the long-held belief of solely hematogenic or primary infection routes for otitis media tuberculosa.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pediatrics
Context:
- Otitis media tuberculosa is a rare condition with debated infection routes.
- Historically, childhood middle ear tuberculosis was attributed to hematogenic or primary infections due to absence of a discernible tuberculous focus elsewhere.
- Previous literature proposed three main routes of infection for otitis media tuberculosa.
Purpose:
- To investigate the infection routes of otitis media tuberculosa in children.
- To present two case studies of pediatric middle ear tuberculosis.
- To evaluate the role of adenoid tissue in middle ear tuberculosis.
Summary:
- Two cases of pediatric otitis media tuberculosa are presented.
- Histological examination of mastoid granulation tissue revealed Langhans cells, and microbiological tests confirmed tuberculosis.
- Subsequent adenoid tissue examination, after adenotomy, also showed tuberculosis, suggesting a potential tubal infection route from the adenoids to the middle ear.
Impact:
- This study suggests a potential alternative infection pathway for otitis media tuberculosa in children.
- It challenges the established understanding of middle ear tuberculosis pathogenesis.
- Highlights the importance of examining adenoid tissue in pediatric cases of middle ear tuberculosis.