Clinical insights into tuberculosis otitis media: diagnosis, treatment, and management outcomes.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2024-09-22 DOI:10.1007/s00405-024-08977-3

Zhe Peng, Zhong-Rui Chen, Hai-Yan Xu, Lin-E Wang, Shu-Sheng Gong

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引用次数: 0

Abstract

Objectives: The diagnosis of tuberculosis otitis media (TBOM) remains a great challenge. This study aims to suggest potential diagnostic clues and proper management of TBOM.

Methods: The study is a retrospective review of TBOM cases that were treated at our department, between January 2015 and June 2023. Summarizing their clinical characteristics, diagnosis, and treatment. Additionally, a literature review is conducted.

Results: Eight cases of TBOM, 6 female and 2 male patients, median age was 32 years old, were included in the study. TBOM mainly presents with symptoms of otorrhea, hearing loss, and occasional early-onset facial palsy. One case had a positive Purified Protein Derivative (PPD) before the operation. Middle ear tissue was pathologically biopsied in 7 cases, with 3 cases testing positive for Acid Fast Bacillus and 6 cases testing positive for Mycobacterium tuberculosis PCR. Middle ear surgery and Anti-tubercular treatment (ATT) were completed in all cases. The median follow-up was 11 months. No cases of TB relapse were observed.

Conclusions: Proper suspicion and confirmation of TBOM is the primary clinical orientation. Middle ear surgery combination with ATT results in satisfactory outcomes. Hearing reconstruction should be performed after ATT is completed.

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结核性中耳炎的临床见解：诊断、治疗和管理结果。

目的：结核性中耳炎（TBOM）的诊断仍是一项巨大挑战。本研究旨在为 TBOM 的潜在诊断线索和正确处理提供建议：本研究对 2015 年 1 月至 2023 年 6 月期间在我科接受治疗的 TBOM 病例进行回顾性分析。总结其临床特征、诊断和治疗。此外，还进行了文献综述：研究共纳入 8 例 TBOM 患者，其中女性 6 例，男性 2 例，中位年龄为 32 岁。TBOM主要表现为耳鸣、听力下降，偶尔会出现早发性面瘫。其中一例患者术前纯化蛋白衍生物（PPD）呈阳性。对 7 例患者的中耳组织进行了病理活检，其中 3 例患者的酸性快速杆菌检测呈阳性，6 例患者的结核分枝杆菌 PCR 检测呈阳性。所有病例均完成了中耳手术和抗结核治疗（ATT）。中位随访时间为 11 个月。未发现结核病复发病例：结论：正确怀疑和确认 TBOM 是临床的首要任务。中耳手术联合 ATT 可取得满意疗效。听力重建应在 ATT 结束后进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.