Computed tomography of the temporal bone in tuberculous otitis media

Abstract

Nine cases of tuberculous otitis media were treated by us over the past 10 years. Six patients presenting with large tympanic membrane perforations were treated for suppurative otitis media at various ENT clinics. The remaining three patients presented without perforation. Intractable otorrhoea, aggravation of hearing loss, dizziness, and in one case facial palsy, resulted in eventual referral to us. Histological examination revealed a tuberculous granulation, confirming the diagnosis in most cases. CT in four cases with profound sensorineural hearing loss showed bone destruction of the otic capsule around the oval window and the promontory. Changes noted included a notch in one case, disappearance of the bony contour around the hook in two cases, and a distinct fistula in the final case. A cochlear fistula seemed to be characteristic of advanced tuberculous otitis media.

Primary Tuberculous Otitis Media: A Case Report

“…[11] The middle ear mucosa may appear pale. [13] Abundant pale granulations appear to be characteristic of tuberculous otitis media. These granulations may be seen filling the middle ear during otoscopy and the mastoid during surgery.…”

“…These granulations may be seen filling the middle ear during otoscopy and the mastoid during surgery. [7,8,13,14,15,16,17] Involvement of the middle ear by tuberculosis has been described in all age groups, though more commonly in children. In the pre-antibiotic era, 2.8% of all the cases of chronic suppurative otitis media were tuberculous in nature and infants below one year of age comprised 50% of these.…”

“…[19] A facial palsy may develop but appears to be more common in those cases of acute mastoiditis caused by mycobacterium tuberculosis occurring in 40% in one series. [19] Conductive hearing loss results from tympanic membrane perforation [13,14] , although hearing disability is disproportionately severe because of progressive disease. Demonstration of chronic caseation necrosis and granuloma formation with epitheloid cells and Langerhan's giant cells…”

Primary tuberculosis of the temporal bone: A rare case report

“…Recent studies have shown that CT is the best imaging modality available for the diagnosis of tuberculous mastoiditis; CT provides more information than do standard plain films and it is more accurate and useful than magnetic resonance imaging. [8,9] Histopathologic examination of the involved middle ear and mastoid mucosa will show three types of changes: miliary, granulomatous, and caseous. The miliary type is associated with superficial infection, the granulomatous type with superficial bony involvement, and the caseous type with massive necrosis and sequestration.…”

Tuberculous Otitis Media and Lupus Vulgaris of Face: An Unusual Association

“…Mastoid X-rays in our patient showed well pneumatized mastoid with no evidence of any haziness or destruction of mastoid air cells. Recent studies have shown that high resolution computed tomography (HRCT) is the best imaging modality for planning therapy by accurately displaying the involvement of the various structures of the middle and inner ear [17].…”