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The Variable Clinical Presentation of Tuberculosis Otitis Media and the Importance of Early Detection

Presenting Author: Franco Louie Abes

Published online by Cambridge University Press:  03 June 2016

Franco Louie Abes ,
Generoso Abes  and
Joselito Jamir
Franco Louie Abes
Affiliation:
Manila Doctors Hospital; University of Santo Tomas Faculty of Medicine and Surgery; Asian Hospital and Medical Center; University of the Philippines National Institutes of Health Philippine National Ear Institute
Generoso Abes
Affiliation:
Manila Doctors Hospital; University of the Philippines Philippine General Hospital - Department of Otorhinolaryngology; University of the Philippines National Institutes of Health Philippine National Ear Institute
Joselito Jamir
Affiliation:
University of the Philippines Philippine General Hospital Department of Otorhinolaryngology
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Abstract

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Learning Objectives:

Introduction: Tuberculosis (TB) is a rare cause of otitis media.This study aims to increase awareness on the clinical presentation of TB otitis media and illustrate how early detection affects treatment outcome.

Methods: Chart review of 12 patients (13 ears) from a tertiaryhospital in Manila, Philippines, seen from 2004 to 2009. Clinical predictors of the disease were summarized. Clinical, radiologic, and audiometric outcomes after treatment were compared between treatment groups.

Results: The 5 otoscopic presentations were multiple perforations, single perforation with refractory otorrhea and exuberantgranulation tissue formation, single perforation with minimal otorrhea and no granulation tissue formation, intact tympanic membrane with middle ear effusion, and intact tympanic membranewith tumorlike tissue in the middle ear. Clinical predictors of the disease were history of pulmonary TB, work-related contamination of the infection, positive purified protein derivative test, positive chest radiographic finding and intraoperative granulation tissue with cheesy material, and temporal bone computed tomographic scan findings. Patients who had no middle ear surgery showed significantly better clinical, radiologic, and audiometric outcomes than those who were diagnosed late and had more complicated surgical procedure.

Conclusion: The clinical presentation of TB otitis media is variable. Early detection of the early forms entail less surgical intervention and favors better treatment results.