[Tuberculosis in the otorhinolaryngologic area. A still current differential diagnosis]

Between 1986 and 1992 18 cases of tuberculosis of the cervical lymph nodes, the larynx, the middle ear, or the paranasal sinuses were diagnosed at the ENT clinic of the University of Erlangen-Nuremberg. A rare case of tuberculous infection of both the maxillary and ethmoidal sinuses and the pharyngeal tonsil is presented. All patients with involvement of the upper respiratory tract had concomitant productive pulmonary tuberculosis, whereas in tuberculous cervical lymphadenitis and otitis media the disease was regularly limited to the neck and the ear respectively. Preoperative microbiological testing pointed to a tuberculous origin in only 3 of the 18 patients, so that histological and microbiological examination of excision biopsy specimens was the most reliable test. As there was no apparent decrease in incidence over the 7 years, we conclude that tuberculosis remains an important differential diagnosis in ENT.