A Clinical, Radiologic Study of Tuberculous Otitis Media / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Tuberculous otitis media is not commonly found nowadays, and therefore, the index of suspicion is often low. However, once contracted, it can cause significant morbidities, such as profound hearing loss, labyrinthitis, facial nerve palsy and so on, if early diagnosis and treatment are not performed. MATERIALS AND METHODS: In the chronic otitis media patients who visited Masan Samsung Hospital from Jan. 1993 to Jan. 1996, 37 cases of pathologically proven tuberculous otitis media were retrospectively reviewed. And temporal bone computerized tomography (TBCT) of 14 cases of tuberculous otitis media were compared to those of chronic suppurative otitis media and choronic otitis media with cholesteatoma. RESULTS: 1) Classic clinical findings of the disease such as multiple perforation, painless otorrhea, young age are not consistent with the clinical findings reviewed here. 2) Unexpectedly severe hearing loss, facial paralysis, eroded malleus handle, polypoid granulation or necrotic debris in middle ear cavity were significant clinical features. 3) In TBCT findings, soft tissue density in the entire middle ear cavity, soft tissue density extension to superior external auditory canal, poor sclerotic change of mastoid air cell were more common than other types of chronic otitis media. 4) Most of cases were confirmed by operative specimen pathologically. 5) Delayed healing of postoperative wound and formation of granulation tissue suggested tuberculous otitis media. 6) Antituberculous chemotherapy provided effective means of treatment. CONCLUSION: Early diagnosis by pathologic examination of biopsied tissue obtained at OPD was mandatory to avoid complication and postoperative morbidity. Postoperative specimen obtained from middle ear surgery must be confirmed pathologically.