Tuberculous Otitis Media Leading to Sequentialib Bilateral Facial Nerve Paralysis

Document Type : Case Report

Authors

Department of Otorhinolaryngology, Govt Medical College and Hospital, Sector-32, Chandigarh, India.

Abstract

Introduction:
Tuberculous otitis media (TOM) is an uncommon, insidious, and frequently misdiagnosed form of tuberculosis (TB). In particular, TOM is usually secondary to direct transmission from adjacent organs, while the primary form has been rarely reported. The main aim of treatment is to start the patient on an antitubercular regime and early surgical intervention to decompress the facial nerve if involved.
 
Case Report:
The case report of a twenty year-old male with bilateral tuberculous otitis media, who presented himself with fever followed by sequential bilateral facial nerve paralysis, bilateral profound hearing loss, and abdominal tuberculosis leading to intestinal perforation, is presented. To the best available knowledge and after researching literature, no such case depicting the extensive otological complications of tuberculosis has been reported till date. 
 
Conclusion: 
Tuberculosis of the ear is a rare entity and in most cases the clinical features resemble that of chronic otitis media. The diagnosis is often delayed due to varied clinical presentations and this can lead to irreversible complications. Early diagnosis is essential for prompt administration of antitubercular therapy and to prevent complications. 

Keywords

Main Subjects


1. Corbett EL , Watt CJ , Walker N , Maher DWilliams BGRaviglione MCet al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.  Arch Intern Med 2003; 163(9):1009-21.
2. Fain O, Lortholary O , Lascaux V, Amoura I, Babinet P, Beaudreuil J, et al. Extrapulmonary tuberculosis in the northeastern suburbs of Paris: 141 cases. Eur J Intern Med 2000; 11(3):145-50.
3. Odetoyinbo O. Early diagnosis of tuberculous otitis media. J Laryngol Otol 1988; 102(2):133-5.
 4. Vital V, Printza A, Zaraboukas T. Tuberculous otitis media: a difficult diagnosis and report of four cases. Pathol Res Pract 2002; 198(1):31-5.
5. Vaamonde P, Castro C, García-Soto N, Labella T, Lozano A. Tuberculous otitis media: a significant diagnostic challenge. Otolaryngol Head Neck Surg 2004; 130(6):759-66.
6. Ricciardiello F , Martufi S , Cardone M , Cavaliere M , D’Errico P, Lengo M. Otorhinolaryngology-related tuberculosis. Acta Otorhinolaryngol Ital 2006; 26(1):38-42.
7. Prasad KC, Sreedharan S, Chakravarthy Y, Prasad SC. Tuberculosis in the head and neck: experience in India.  J Laryngol Otol 2007; 121(10):979-85.
8.  Nalini B, Vinayak S. Tuberculosis in ear, nose, and throat practice: its presentation and diagnosis. Am J Otolaryngol 2006; 27(1): 39-45.
9.  Awan MS, Salahuddin I. Tuberculous otitis media: two case reports and literature review. Ear Nose Throat J 2002; 81(11):792-4.
10.  Chirch LM, Ahmad K, Spinner W, Jimenez VE, Donelan SV, Smouha E. Tuberculous otitis media:
report of 2 cases on Long Island, N.Y., and a review of all cases reported in the United States from 1990 through 2003. Ear Nose Throat J 2005;84(8):488, 490, 492 passim.
11. Sens PM, Almeida CI, Valle LO, Costa LH, Angeli ML. Tuberculosis of the ear, a professional disease? Braz J Otorhinolaryngol 2008; 74(4):621-7.
12. Cho YS, Lee HS, Kim SW, Chung KH , Lee DK , Koh WJ , Kim MG. Tuberculous otitis media: a clinical and radiologic analysis of 52 patients. Laryngoscope 2006; 116(6):921-7. 
13. Skolnik PR, Nadol JB Jr, Baker AS. Tuberculosis of the middle ear: review of the literature with an instructive case report. Rev Infect Dis 1986; 8(3):403-10. 
14. Meher R, Singh I, Yadav SP, Gathwala G. Tubercular otitis media in children. Otolaryngol Head Neck Surg 2006; 135(4):650-2.
15. Bhalla RK, Jones TM, Rothburn MM, Swift AC. Tuberculous otitis media-a diagnostic dilemma. Auris Nasus Larynx 2001; 28(3):241-3. 
16. Lee PY, Drysdale AJ. Tuberculous otitis media: a difficult diagnosis. J Laryngol Otol 1993; 107(4):339-41. 
17. De Paep K, Offeciers FE, Van de Heyning P, Claes J, Marquet J. Tuberculosis in the middle ear: 5 case reports. Acta Otorhinolaryngol Belg 1989; 43(4):321-6. 
18. Yaniv E. Tuberculous otitis: an underdiagnosed disease. Am J Otolaryngol. 1987; 8(6): 356-60.
19. Kirsch CM, Wehner JH, Jensen WA, Kagawa FT, Campagna AC. Tuberculous otitis media. South Med J 1995; 88(3): 363-6.
20. Windle- Taylor PC, Bailey CM. Tuberculous otitis media: A series of 22 patients. Laryngoscope 1980; 90 (6 Pt 1): 1039-44.
21. Rho MH, Kim DW, Kim SS, Sung YS, Kwon JS, Lee SW. Tuberculous otomastoiditis on high-resolution temporal bone CT: comparison with nontuberculous otomastoiditis with and without cholesteatoma. Am J Neuroradiol 2007; 28(3):493-6.