ABSTRACT
This study was conducted to determine the frequency of primary tuberculous otitis media [TOM] in north-west region of Pakistan. This observational study was conducted at ENT and Head and Neck Surgery unit of Naseer Teaching Hospital, Peshawar from 1st April 1999 to 31st March 2005. Diagnosed cases of primary tuberculous otitis media were included. The inclusion criterion was histopathology of biopsy specimen and acid-fast bacilli [AFB] examination of ear discharge after Ziel Nielsen [ZN] staining. Patients with pulmonary tuberculosis were excluded from study. A total of 12 cases of primary tuberculous otitis media were included. Young adults [15-56 years] were mainly affected. Majority [66.66%] of patients belonged to Afghanistan. Main presenting features were painless otorrhoea in 12 cases [100%] followed by abundant granulations, total perforation and failure to conventional medical therapy in 9 cases [75%] each. Ten cases [83.30%] were diagnosed on presence of granulation on histological examination while 2 cases [16.7%] were diagnosed on AFB demonstration after ZN staining. Anti-tuberculous chemotherapy was given to all patients and surgical treatment was offered to 8 patients. Four patients had radical mastoidectomy, 3 underwent aural polypectomy and 1 had simple [cortical] mastoidectomy. Response to chemotherapy was tremendous [100%]. Six patients from Afghanistan were lost to follow up. The primary TOM in northwest region of Pakistan is more common in Afghan refugees. TOM, when properly diagnosed, has got excellent response to chemotherapy