Concomitant Nasopharyngeal and Otomastoid Tuberculosis: a Report of 3 Cases and a Review of Literature.

Objective: Concomitant nasopharyngeal and otomastoid tuberculosis (TB) is an extremely rare clinical condition. So far, there have only been 2 such cases reported in English literature, and another 2 such cases have been reported in Chinese literature. The objective of this work is to summarize our experience dealing with this condition and to review the literature. Methods: A retrospective review of cases with concomitant nasopharyngeal and otomastoid TB treated at 2 tertiary medical institutions between June 2022 and May 2024 was undertaken. Data were retrieved from case notes and analyzed. Results: In total, 3 cases were included (2 male patients were from the former institution, and 1 female patient was from the latter). One case was bilateral, and the other 2 cases were unilateral. Their age was between 23 years old and 49 years old (average and median age was 36.3 and 37 years old, respectively). Presenting symptoms included ear fullness, hearing loss, otorrhea, facial paralysis, and otalgia. Careful diagnostic work-up led to the discovery of both otomastoid and nasopharyngeal lesions in all patients. Surgical procedures were planned, and histopathological examination of lesions of both sites was suggestive of TB for all cases, while polymerase chain reaction (PCR) confirmed the presence of Mycobacterium tuberculosis. All patients were subjected to 6 months of anti-TB treatment. The median duration of follow-up was 10 months. No recurrence was documented. A summary of all 7 such cases was also presented. Conclusions: Concomitant nasopharyngeal and otomastoid tuberculosis is very rarely encountered. Surgery or surgical biopsy is important for both treatment and diagnosis. After confirmation of TB by histopathology and PCR, anti-TB treatment is very important for the prevention of recurrence. Symptoms could generally be improved, although not always optimistic.