結核性中耳炎の二症例とその病態についての考察

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  • TWO CASES OF TUBERCUROUS OTITIS MEDIA
  • ケッカクセイ チュウジエン ノ ニショウレイ ト ソノ ビョウタイ ニ ツイテ

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Two cases of the tuberculous otitis media were reported. The first case (8-year-old female) visited Branch Hospital, University of Tokyo with a chief complaint of otalgia and otorrhea. Otoscopic examination revealed a central perforation and mucopurulent discharge. The infection was resistent to the usual antibiotic therapy and a dirty whitish yellow mass appeared. Thus, tuberculous otitis was strongly suspected and debridement of the involved part of the ear was performed with a satisfactory result. The diagnosis was established by histological examination.<br>The second case (30-year-old female) had a past history of otitis media since childhood. She underwent operation because of the repetitive inflammation. However, discharge reappeared 2 months after the operation. Enlarging of the perforation and the production of a dirty mass was observed, and the facial paresis appeared 7 months after the operation. Then, tuberculous otitis media was suspected and the involved tissue was removed surgically. Tuberculous infection was verified histologically. She showed a satisfactory wound healing 8 months after the second operation and facial paresis was recovered with antituberculous drugs.<br>Summarizing these two cases, no specific features were noted on the otoscopic examination in the out-patient clinic. However, these two cases showed enlargement of the perforation and the dirty whitish mass in the tympanic cavity resistent to the usual therapy. These findings seemed to be indicative of tuberculous otitis media.<br>The survey of literature also lead us to the conclusion that otitis media resistent to the usual therapy and the production of whitish mass strongly suggest the tuberculous otitis.<br>The pathology of tuberculous infection was discussed referring to its clinical features.

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