Sebastian Susan K, Vijayan Vikas, Kumar Vibhor B, Garg Payal
Department of ENT and Head & Neck Surgery, St Stephen's Hospital, Delhi, India.
Int J Pediatr Otorhinolaryngol. 2020 Aug;135:110118. doi: 10.1016/j.ijporl.2020.110118. Epub 2020 May 13.
Four cases of tuberculous otitis media in children are reported. One case presented with a postaural fistula, another case with signs of meningeal irritation and ear discharge and two cases as chronic otitis media refractory to conventional treatment. All patients underwent modified radical mastoidectomy and the diagnosis was made postoperativelyby histopathology in three cases and Ziehl-Neelson stainig of the discharge from the mastoid cavity in one. Clinical presentation and management of the cases are discussed. Tuberculosis should be considered in the diagnosis of children with chronic otitis media not responding to conventional antibiotic treatment.Targeted chemotherapy along with surgery provides rapid and complete healing.
本文报告了4例儿童结核性中耳炎病例。1例表现为耳后瘘管，另1例有脑膜刺激征和耳漏，2例为常规治疗无效的慢性中耳炎。所有患者均接受了改良乳突根治术，3例术后经组织病理学确诊，1例经乳突腔分泌物齐-尼氏染色确诊。文中讨论了这些病例的临床表现及治疗方法。对于常规抗生素治疗无效的慢性中耳炎患儿，诊断时应考虑结核病。针对性化疗联合手术可实现快速、完全治愈。
