Ear tuberculosis: Clinical and surgical treatment

Chmielik, Lechosław P.; Ziółkowski, Jerzy; Koziołek, Renata; Kulus, Marek; Chmielik, Mieczysław

doi:10.1016/j.ijporl.2007.10.008

Cited by 17 publications

(12 citation statements)

References 9 publications

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“…We suppose that in our patient two latter ways were possible -hematogenously from the active pulmonary loci or via Eustachian tube from the nasopharynx as the both temporal bones were involved. Previous investigators proposed that surgical treatment might be useful in case of facial nerve paralysis [6]. In our case the symptoms of the latter condition improved with antituberculous therapy.…”

Section: Discussionsupporting

confidence: 54%

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Agresyvi Abipusė Smilkinkaulių Tuberkuliozė. Klinikinis Atvejis

Kornilenko

Arechvo

2017

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: smilkinkaulio tuberkuliozė, persistuojanti otorėja, veidinio nervo parezė. Smilkinkaulio tuberkuliozė -reta būklė, jai būdingas specifinių simptomų nebuvimas, todėl laiku nenustatoma diagnozė. Dėl ligos retumo ir klinikinių simptomų įvairovės diagnozuodami tuberkuliozinį vidurinį otitą otologai turi būti itin budrūs. Kad atkreiptume gydytojų klinicistų dėmesį į šią patologiją, pristatome unikalų agresyvios eigos vidurinės ausies ir gretimų struktūrų tuberkuliozės atvejį. Iš pradžių ši būklė pasireiškė nespecifinio pūlingo vidurinės ausies uždegimo simptomais. Buvo taikomas įprastas gydymas sisteminiais ir vietiniais priešbakteriniais ir priešgrybeliniais preparatais, tačiau liga progresavo: pasireiškė būgninės ertmės gleivinės ir klausomųjų kauliukų staigus irimas, atsirado pilkų blyškių granuliacijų vidurinėje ausyje. Didelės skiriamosios gebos smilkinkaulių kompiuterinė tomografija, atlikta ligos pradžioje, parodė nespecifinį abipusį otomastoiditą, normalios pneumatizacijos spenines ataugas abipus ir nepakitusias atiko lateralines sienas. Ligoniui išsivystė veidinio nervo paralyžius ir smilkinkaulio osteomielito požymiai. Diagnozuojant vidurinės ausies tuberkuliozę, buvo remiamasi klinikinių simptomų, kompiuterinės tomografijos duomenimis ir pulmonologo patvirtinta recidyvuojančios plaučių tuberkuliozės diagnoze. Kruopščiai surinkta anamnezė, atkreipiant dėmesį į buvusią ar esamą plaučių tuberkuliozę, būtina teisingai diagnozei patvirtinti. ABSTRACTKey words: temporal bone tuberculosis, persistent otorrhea, facial nerve palsy. Temporal bone tuberculosis is a rare condition with a lack of disease-specific signs. Due to the rarity and variety of clinical manifestations, tuberculous otitis media is requiring a high index of suspicion among otologists. To increase awareness of this condition, we report the unique recent case of bilateral aggressive tuberculous otitis media. The disease presented as an unspecific purulent otitis media. In spite of the conventional treatment with systemic and topic antibacterial and antifungal preparations more suspicion symptoms occurred: sudden disappearance of the ossicular and tympanic cavity mucous membrane, nodular granulations in the middle ear cleft. Unspecific otomastoiditis without sclerotic changes and scutum destruction was radiologically diagnosed at the beginning. Facial palsy and osteomyelitis of the temporal bone with sequestration were estimated. The diagnosis was put forward basing on the clinical symptoms, computed tomography data and reactivated pulmonary tuberculosis confirmed by pulmonologist. Thorough history with special emphasis to the previous lung tuberculosis is crucial for establishing of the correct diagnosis. Irina ArechvoKaroliniškių poliklinikos Otorinolaringologijos konsultacijų skyrius L. Asanavičiūtės g. 27a, Vilnius

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Section: Discussionsupporting

confidence: 54%

“…Previous authors put a special attention on early TOM diagnosis establishment and as soon as possible beginning of specific antituberculous treatment because of destructive nature of disease [6].…”

Section: Discussionmentioning

confidence: 99%

Agresyvi Abipusė Smilkinkaulių Tuberkuliozė. Klinikinis Atvejis

Kornilenko

Arechvo

2017

Medicinos Teorija Ir Praktika

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“…It is still necessary for our patient to take tuberculostatics for some time until complete healing. After that, the otolaryngologist will decide if it is necessary to reconstruct the tympanic membrane (20).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Occupational Middle Ear Tuberculosis in a Nurse

Lalić

Kukuljan

Pavicić³

2010

Archives of Industrial Hygiene and Toxicology

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This article presents a case of a 40-year-old female patient with a right-side middle ear tuberculosis. The patient was a nurse, who had worked at the Department of Pulmology, Clinical Hospital Rijeka for 17 years. The cause was infection with Mycobacterium tuberculosis while she assisted in bronchoscopy. The patient was referred to occupational medicine (OM) for confi rmation of occupational disease immediately after surgery. The disease was confi rmed as occupational by the Croatian Institute for Health Insurance of Health Protection at Work. During surgery a sample was taken for microbiological analysis. We did initial and control multislice computed tomography (MSCT) and control magnetic resonance imaging (MRI) of temporal bones 6 months after the surgery. The initial MSCT showed total mastoid cell shadowing without destruction, while the control image showed almost full recovery save for a few remaining shadowed cells. Adequately taken occupational history by an OM specialist can signifi cantly shorten the time to diagnosis of a rare occupational illness that is often manifested by non-specifi c symptoms.

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“…Tuberculous infection of the middle ear is often primary by inoculation from the external auditory canal through a tympanic membrane perforation. However, 50% of cases of ear tuberculosis in children are secondary and a primary focus of infection may be apparent elsewhere 12. Signs of ear tuberculosis include granulations in the external auditory canal, hearing loss and facial palsy 4 11 12.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…However, 50% of cases of ear tuberculosis in children are secondary and a primary focus of infection may be apparent elsewhere 12. Signs of ear tuberculosis include granulations in the external auditory canal, hearing loss and facial palsy 4 11 12. Retrograde spread of infection from the mastoid could involve the petrous apex 11.…”

Section: Differential Diagnosismentioning

confidence: 99%

A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess

Muranjan¹,

Karande²,

Parikh³

et al. 2014

BMJ Case Reports

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SUMMARYA 5-year-old girl presented with a 3-month history of left side facial palsy, followed sequentially by purulent ear discharge, complete external ophthalmoplaegia and blurred vision. On clinical examination she was febrile with left-sided conductive hearing loss. She was clinically diagnosed to have chronic suppurative otitis media of the unsafe type with petrous apicitis, middle cranial fossa abscess and cavernous sinus involvement. Preliminary CT scan findings were reported as a large left temporal lobe abscess and left otitis media with cholesteatoma. MRI of the brain obtained later corroborated the abnormalities detected on the CT scan. Ten days after admission, a mass was seen protruding from the external auditory canal. A biopsy of the mass was obtained and sent for histopathological examination. Meanwhile, review of the MRI suggested an aggressive neoplasm such as sarcoma/ rhabdomyosarcoma. Histopathology clinched the final diagnosis of an anaplastic type of embryonal rhabdomyosarcoma of the middle ear cleft. BACKGROUND

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Ear tuberculosis: Clinical and surgical treatment

Cited by 17 publications

References 9 publications

Agresyvi Abipusė Smilkinkaulių Tuberkuliozė. Klinikinis Atvejis

Agresyvi Abipusė Smilkinkaulių Tuberkuliozė. Klinikinis Atvejis

A Case Report of Occupational Middle Ear Tuberculosis in a Nurse

A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess

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