Tubercular Otitis Media Important points: ––Seen mainly in children and young adult Q ––It is secondary to pulmonary tuberculosis. Q ––Route of spread - Mainly through eustachian tube (not blood borne). Q Symptoms: 1. Patients often present with chronic painless otorrhoea (usually foul smelling) which is resistant to antibiotic treatment Q 3. Severe conductive type hearing loss Q. (sometimes due to involvement of labyrinth may be SNHL) 4. Facial nerve palsy may be the presenting symptom in childrenQ 5. Cough; fever and night sweats may be present in patients with tuberculous infection in other organ system. O/E –– Multiple perforationsQ in tympanic membrane (This feature was once considered characteristic of TB but now is seldom seen). –– Middle ear and mastoid are filled with pale granulation tissueQ (It is a characteristic of tuberculous otitis media) Complications: (Early onset of these symptoms is seen) ––Mastoiditis ––Osteomyelitis ––Postauricular fistula ––Facial nerve palsy
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