Tuberculosis in the Head and Neck in India: Down but not yet Dead

Abstract

Background: The aim of this study was to evaluate the various manifestations of tuberculosis in the head and neck region, incidence of the different forms and the diagnostic modalities and the treatment modalities employed. We also studied its coexistence with pulmonary tuberculosis and human immunodeficiency virus infection. Methods: Our study was a prospective study done conducted in the otolaryngology and head and neck surgery departments, Kasturba medical college and allied hospitals in Mangalore, India. The study group comprised 70 patients diagnosed with tuberculous manifestations of the head and neck region over the period of 2 years from 2011-2013. Chest radiography and sputum AFB was also done in all the patients to rule out coexisting pulmonary tuberculosis. All patients were screened for HIV. Results: Our study included 70 patients with tuberculosis of the head and neck region. The most common presentation of tuberculosis in the head and neck region was tuberculous lymphadenitis in 77% followed by deep neck space abscess 10% then laryngeal tuberculosis in 8.50%, submandibular gland tuberculosis in 3% and 1.5% diagnosed with pharyngeal tuberculosis. 12.8% of our patients had coexisting HIV infection and 33% patients had associated pulmonary tuberculosis. Conclusions: Tuberculosis of the head and neck region though not very frequent, still remains an important clinical entity which should be kept in mind especially in developing countries. Involvement of the cervical lymph nodes remains one of the commonest manifestations.