Tuberculous Otitis Media: A Significant Diagnostic Challenge

Abstract

OBJECTIVE: This study was undertaken to revise the diagnostic characteristics of tuberculous otitis media (TOM), a disorder that is often diagnosed late, leading to delay in specific treatment. STUDY DESIGN AND SETTING: Retrospective study of a longitudinal series of 10 TOM patients over a 7-year period at an institutional referral center. RESULTS: Most patients showed intractable otorrhea, moderately severe hearing loss, and necrotic eardrums with granulation tissue and single perforations. Multiple perforations, facial palsy, and cervical adenopathies were rare (<10% of patients). CT generally showed soft tissue involvement of the middle ear without bone erosion. The most effective laboratory test microbiological culture of exudate (diagnostic efficacy 71%). Specific antibiotic treatment was effective in all cases. CONCLUSION: The diagnosis of TOM remains a significant challenge for otorhinolaryngologists. SIGNIFICANCE: If there are strong clinical grounds for suspicion, standard laboratory tests for tuberculosis should be repeated even if initially negative. (Otolaryngol Head Neck Surg 2004;130:759-66.)