The aim of this study was to increase awareness of the different presentations of head and neck tuberculosis (TB) and to discuss its diagnostic difficulties. A prospective study of patients who presented to us, at a tertiary referral hospital, primarily with TB of head and neck was done from September 2014 to August 2016. Patients were categarised into proper category of Anti Tuberculous Treatment (ATT) and were treated according to ATT regimen. All patients were followed up at 2months and 6months after starting ATT. A total of 170 patients presented with primary head and neck TB during the study period. Most of these (96%) had cervical lymphadenopathy, 5 patients had laryngeal TB, and there was 1 patient each of TB of middle ear. 102 were males, and 68 were females. 25.8% of cases had associated pulmonary TB. (1) Diagnosing TB requires a high index of suspicion. (2) Tuberculosis of the cervical lymph nodes is the commonest presentation followed by laryngeal TB. (3) Fine needle aspiration cytology (FNAC) is a reliable and easy way to diagnose TB. However, newer diagnostic tests will increase the yield of positive cases and should be used whenever required. (4) In the larynx, the vocal cords were the commonest site affected and laryngeal TB need not be associated with lung TB or positive sputum always. (5) Patients who have TB of head and neck must be investigated to exclude pulmonary or systemic TB.
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