El Ayoubi A, Benhammou A, El Ayoubi F, El Fahssi A, Nitassi S, Kohen A, Nazih N, Benbouzid A, Kzadri M
Service d'ORL et de chirurgie maxillofaciale, hôpital des spécialités, CHU de Rabat, 31, rue Immame El Ghazzali, Souissi, Rabat, Morocco.
Ann Otolaryngol Chir Cervicofac. 2009 Sep;126(4):208-15. doi: 10.1016/j.aorl.2009.06.007. Epub 2009 Aug 4.
The aim of this sinusonasal study was to study several locations of ENT extranodal tuberculosis.
Our study focused on eight cases of tuberculosis in the cervicofacial region gathered in the ENT department of the Rabat Specialization Hospital (Morocco) between August 2004 and August 2006. They comprise two cases of rhinopharyngeal tuberculosis, two cases of tuberculosis, two cases of endobuccal tuberculosis (mandibular and lingual locations), and two cases of glandular tuberculosis (thyroid and parotid locations).
These locations are rarely affected by tuberculosis. The clinical signs as well as radiology and endoscopy are not specific. The final diagnosis is based on histology. Bacillus cultures are necessary when caseum tuberculosis is not found, causing problems of differential diagnosis with granulomatous and malignant lesions. PCR provides quick bacterial antigen detection when cultures are negative. The treatment provides a quick and complete recovery while recurrences are infrequent.
ENT tuberculosis is rare if excluding the nodal locations. It should be mentioned as a differential diagnosis, especially in endemic areas. Most often, this is a surprise diagnosis.
本鼻窦研究的目的是研究耳鼻喉科结外结核的几个发病部位。
我们的研究聚焦于2004年8月至2006年8月期间在拉巴特专科医院(摩洛哥)耳鼻喉科收治的8例面颈部结核病例。其中包括2例鼻咽结核、2例口腔结核(下颌和舌部发病部位)以及2例腺结核(甲状腺和腮腺发病部位)。
这些发病部位很少受到结核影响。临床症状、放射学表现及内镜检查均不具有特异性。最终诊断基于组织学检查。当未发现干酪样结核时,需进行杆菌培养,这会导致与肉芽肿性病变及恶性病变的鉴别诊断问题。当培养结果为阴性时,聚合酶链反应可快速检测细菌抗原。治疗能实现快速且完全的康复,复发情况并不常见。
若排除淋巴结发病部位,耳鼻喉科结核较为罕见。应将其作为鉴别诊断提及,尤其是在地方性流行区域。大多数情况下,这是一种意外诊断。