结核性鼓膜炎:对鼓膜完整的耳科结核病的分析

Nandini Gupta, Divyanshu Sharma, D. Parikh
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摘要

近年来,肺外结核越来越多地与免疫缺陷患者的乳突炎联系在一起。虽然乳突结核或耳乳突炎是当今非常罕见的结核病并发症,但一旦发生,可能会导致严重的发病率。可能会出现面瘫和永久性听力损失等并发症。我们的目的是评估结核性耳软骨炎的鉴别诊断结果,并评估在接受手术的同时接受抗结核治疗的患者比只接受抗结核治疗的患者的治疗效果。我们对 12 例 TOM 病例进行了复查,所有病例均在中耳粘膜活检后经痰液和病理检查证实。神经放射学专家分析了 HRCT颞骨的典型发现。根据病变的程度,计划进行鼓室成形术。整个中耳腔的软组织衰减并延伸至外耳道(EAC)或骨性外耳道粘膜增厚、听小骨和颅骨侵蚀具有临床意义。与只接受抗结核药物治疗的患者相比,接受鼓室成形术的患者预后较好。肺外结核病患者,尤其是耳乳突炎患者,应在接受抗结核治疗的同时进行手术切除病灶,以防止并发症的发生。
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Tuberculous otomastoiditis: analysis of otological tuberculosis with intact tympanic membrane
In recent years extra pulmonary tuberculosis has more frequently been associated with mastoiditis in patients with immunodeficiency state. Although tuberculosis of the mastoid or otomastoiditis is a very rare complication of tuberculosis today, when occurs it may cause significant morbidity. Complications such as facial paralysis and permanent hearing loss may develop. Our purpose was to evaluate the differential findings of tuberculous otomastoiditis and evaluation of outcomes in patients undergoing surgery along with anti-tubercular therapy rather than patients receiving only anti-tubercular therapy. We reviewed 12 cases of TOM, all of which had been confirmed on sputum and pathological examination following middle ear mucosal biopsy. Neuroradiologists analyzed the typical findings of HRCT temporal bone. Tympanomastoid ear surgery was planned according to the extent of the disease involved. The soft tissue attenuation in the entire middle ear cavity and extension to the external auditory canal (EAC) or mucosal thickening of the bony EAC, erosion of the ossicles and scutum was clinically significant. Patients who underwent tympanomastoid surgery showed better prognosis than the patients receiving anti tubercular drugs alone. Patients with extra-pulmonary tuberculosis, especially otomastoiditis should get operated to remove the disease along with anti-tubercular treatment to prevent complications.
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