Tuberculous Otitis Media: a case report of hearing impairment in developing country

Giovanni Reynaldo, Bernadina Chyntia Carsantiningrum, Harim Priyono

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Tuberculosis is one of major health problems in developing countries, especially extrapulmonary tuberculosis. Tuberculous otitis media (TOM) is one of extrapulmonary manifestations which is a rare phenomenon characterized by painless otorrhea, insidious onset of ear discharge, multiple perforations in the tympanic membrane, and pale granulation tissues in middle ear cleft. Purpose: Reporting one rare case of TOM. Case Report: A 58-year-old male came with painless otorrhea and recurrent hearing impairment. Tympanomastoidectomy was carried out to repair the tympanic membrane, to cleanse the secret from the middle ear, and to obtain sample for biopsy. Histopathological examination showed necrotizing granuloma which contained mycobacterium tuberculosis infection. Medical treatment was administration of anti tuberculosis drugs. Clinical Question: How to establish TOM diagnosis? Review Method: Searching for literature evidence through Google Scholar. Result: The search obtained 20 journals which in accordance with the inclusion and exclusion criteria. There were similarities on clinical and therapeutic symptoms with this reported case. Discussion: In the reported case, the probable pathophysiology was bacterial aspiration through the Eustachian tube, which was just diagnosed during pre-operative screening. There was no apparent pulmonary tuberculosis symptom. Diagnosis TOM with mastoiditis was difficult, it required high skilled accuracy. Conclusion: TOM is a rare manifestation of extrapulmonary tuberculosis. High suspicion of TOM is needed in patients who did not respond to standard treatment. Treatment includes administration of anti-tubercular drugs, and surgical procedure to cleanse the secretion and granulation tissues. Permanent hearing loss can occur in cases of delayed diagnosis.

Original languageEnglish
Pages (from-to)159-166
JournalOTO RHINO LARYNGOLOGICA INDONESIANAOTO RHINO LARYNGOLOGICA INDONESIANA
Volume50
Issue number2
DOIs
Publication statusPublished - 2 Jan 2021

Keywords

  • Otitis media
  • tuberculous
  • hearing loss
  • otorrhea

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