A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB across all frequencies in the left ear; high-resolution computed tomography of the temporal bone revealed that the mastoid and tympanic cavity were completely obscured. The intraoperative finding showed a caseous space-occupying mass that completely filled the tympanic cavity. The suspected diagnosis of tuberculosis was corroborated by pathohistological, microbiological and molecular biological tests. Tuberculostatic therapy was initiated at a different location. Although tuberculosis of the middle ear is a rare condition in Germany, it should nevertheless be considered when making a differential diagnosis, especially in high-risk patients where cholesteatoma is suspected on clinical and radiological evidence or in patients with a chronic middle ear process.
Tinnitus is a common symptom in a variety of otologic diseases and is frequently accompanied by loss of hearing. In recent years, the pervasiveness of the problem of subjective tinnitus has stimulated research with the following goals: to determine the frequency of tinnitus in certain diseases; to identify the anatomical source of ‘the noise’; to discover the neural mechanisms which generate this auditory pheonomena; and to find appropriate treatments.
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