Tuberculous otitis media: clinical aspects of 12 cases.

The clinical features of tuberculous otitis media (TOM) have changed. This study was performed to evaluate changing trends in the clinical manifestations of TOM. We reviewed a series of 12 cases of TOM (13 ears) recently treated at Osaka Prefectural Habikino Hospital. The results showed a mean age of 41 years and a male predominance of 1.4 to 1. Central or total perforations of the tympanic membrane were observed in most cases, but none of the patients had multiple perforations. Nine patients (75%) had active pulmonary tuberculosis. Normal lung status or inactive pulmonary tuberculosis was significantly more frequent in the older age group. Diagnosis of primary TOM required more time than that of secondary TOM. Most cases of primary TOM had high infectiousness of the primary lesion. We summarize the clinical features of patients who should be evaluated for TOM.

[Report of 2 cases of tuberculous retoropharygeal abscess in adults].

We report 2 cases of tuberculous retoropharyngeal abscess. Case 1 was a 21-year-old man with tuberculous cervical spondylitis and pulmonary tuberculosis and Case 2 was a 32-year-old woman with tuberculous lymph adenitis and military tuberculosis. Both reported sore throat and dysphagea. In case 1, throat examination showed a bulging abscess at the posterior wall of the pharynx. X-ray examination of the neck showed a massive soft tissue swelling on the lateral view. As soon as the diagnosis was established, prompt focal aspiration was done since the increasing danger of grave respiratory distress was expected. And moreover, surgical incision and drainage of retropharyngeal abscess were indicated. In case 2, intraoral midline incision through the posterior wall of the pharynx was administered because the abscess was small and limited. Though various tuberculous statics and antibiotics are available, tuberculous retropharyngeal abscess still occurs and should be considered to ensure rapid adequate attention to diagnosis and treatment.