結核性中耳炎の８例について

Abstract

Eight cases (10 ears) of tuberculous otitis media are reported. These patients visited our clinic between 1988 and 1989. Seven of the 8 cases were previously treated as chronic otitis media at some other E. N. T. clinics. As five of these 8 cases were once treated in a certain clinic, iatrogenic implanted infection at that clinic was strongly suspected. Characteristic features of the symptoms were remedy-resistant otorrhea, otalgia, progressive hearing loss and facial paralysis. Important local findings for diagnosis were pale granulation tissue covered with thick fibrinoid material and presence of bare bone on the promontory. Combined use of antituberculous medicines, such as isoniazid, ethambutol, rifampicin, was effective for treatment. Although facial paralysis and progressive hearing loss occurred during the use of these medicines in the non-operated group, none of these complications were seen in patients who had had surgery before the use of these medicines. Eradication of the infection by surgery may be preferable in some cases of tuberculous otitis, especially in cases with bone erosion on the CT images.