2008 Volume 51 Issue 1 Pages 33-42
The clinical features of tuberculous otitis media have been changed. This study was undertaken to revise the diagnostic characteristics of tuberculous otitis media (TOM), a disorder that is often diagnosed at a relatively late stage, leading to delays in specific treatment. We reviewed a series of 7 cases of recently treated TOM. The mean patient age was 31.6 years, and most of the patients were women (female: male ratio, 6:1). Most patients showed intractable otorrhea, moderately severe hearing loss, and necrotic eardrums with single perforations. None of the patients had multiple perforations. Five patients had active pulmonary tuberculosis and three patients had epipharynx tuberculosis. Most cases of TOM that were caused by transmission via the Eustachian tube tended to resemble otitis media with effusion during the early stage of disease. Histological examination revealed tuberculous granulation, confirming the diagnosis in most cases. Temporal bone CT scans demonstrated relatively well-pneumatized mastoids and occupation in the soft tissue of the entire tympanum and mastoid air cells without bone erosion. Clinicians should have a high index of suspicion and should be aware of the clinical and radiological characteristics of TOM.
