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Introduction: Tuberculosis (TB) of the head and neck is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge.Purpose: The aim of this study is to discuss diagnostic problems of the extra nodal ENT TB and to analyze its epidemiological and clinical specificities.Patients and methods: We report a study of 21 cases of extra-nodal locations of TB managed in the ENT department of the Habib Thamer Hospital of Tunis between 2003 and 2012.Results: The disease affected the nasopharynx in 13 cases, the tonsils in 3 cases and the larynx in 2 cases. The parotid gland, the thyroid gland and the rhinosinus were compromised in one case each. The clinical signs as well as radiology and endoscopy are not specific. Diagnosis was based on histopathological examination. All our patients received anti-tubercular chemotherapy. The evolution was favorable with 12 months average outcome.Conclusion: There are no pathognomonic features indicative of this disease. It is important for otolaryngologists to mention TB as a differential diagnosis in head and neck malignancies and other chronic non infective and infective pathological conditions. Early diagnosis and therapy may prevent needless and risky surgery.

Citation Tympanoplasty Outcomes in Dry and Wet EarsPage 51 Research ABSTRACT Introduction: Chronic suppurative otitis media is a major public health problem in children and adults. Tympanoplasty is a surgical procedure which aims to prevent recurrent otorrhea and restore hearing ability. Objective: To compare the graft uptake and the hearing outcome of tympanoplasty in non cholesteatomatous chronic otitis media between wet and totally dry ears. Methods: A total of 108 wet ears (with mucoid discharge) and 232 dry ears (at least 3 months before surgery) with chronic suppurativeotitis media were operated on by myringoplasty between 2000 and 2014. Postoperative graft uptake and hearing gain rates were compared between both groups. Results: Cartilage was used in 100% of wet ears and 35% of dry ears. In the other cases, temporalis fascia was the chosen graft. Anatomical success rate was 88% for the wet ear group and 87.5% for the dry ear group. The hearing gain rate was 62%% for the wet ear group and 56% for the dry ear group. Differences were found to be statistically non significant for both graft intake (p=0.9) and hearing gain (p=0.29). In the wet ear group, only age <40 years was found to be a predictive factor of audio logical success in tympanoplasty (p=0.001). Conclusion:The success of myringoplasty is not adversely affected by the presence of mucoid ear discharge at time of surgery, and outcomes are comparable to those of the operation done for dry ears.