Kang Yun Jin, Cho Jin-Hee
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea.
J Clin Tuberc Other Mycobact Dis. 2024 Jun 9;36:100455. doi: 10.1016/j.jctube.2024.100455. eCollection 2024 Aug.
Nasopharyngeal tuberculosis is a rare form of tuberculosis in which Mycobacterium tuberculosis infects the nasopharyngeal tissue. In this study, we analyzed key clinical features to prevent misdiagnosis and to raise awareness of the condition, while recommending suitable treatments. We also report a case of nasopharyngeal tuberculosis presenting with nasal congestion and intermittent ear fullness, contributing valuable educational insight for diagnosis.
Demographic and clinical data from patients with nasopharyngeal tuberculosis were collected from PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials up to September 2022. In total, 280 patients from 69 studies were analyzed.
Reports indicate that the incidence of nasopharyngeal tuberculosis has doubled every decade, particularly in Asia. Most patients are female, presenting with granulomatous pathology and findings such as masses, lymphoid hyperplasia, polypoid formations, or swelling on endoscopic examination. Common symptoms include nasal obstruction, hearing impairment, sore throat, and dysphagia, usually accompanied by cervical lymphadenopathy. The mean duration from symptom onset to diagnosis is ∼2.88 months, and the average time from the start of treatment to resolution of symptoms is ∼ 4.90 months. The antituberculosis treatment regimen and duration are significantly associated with the time to resolution (r = -0.648, p = 0.003 and r = 0.584, p = 0.028, respectively).
These results suggest that an extended regimen of antituberculosis drugs may expedite symptom relief. However, there is a need for more standardized data on patient outcomes and treatment efficacy due to the current lack of comprehensive data.
鼻咽结核是一种罕见的结核病形式，结核分枝杆菌感染鼻咽组织。在本研究中，我们分析了关键临床特征，以防止误诊并提高对该疾病的认识，同时推荐合适的治疗方法。我们还报告了一例以鼻塞和间歇性耳闷为表现的鼻咽结核病例，为诊断提供了有价值的经验见解。
截至2022年9月，从PubMed、Embase、科学网和Cochrane对照试验中央注册库收集鼻咽结核患者的人口统计学和临床数据。总共分析了来自69项研究的280例患者。
报告显示，鼻咽结核的发病率每十年翻一番，尤其是在亚洲。大多数患者为女性，表现为肉芽肿性病理及在内镜检查中发现肿物、淋巴组织增生、息肉样形成或肿胀。常见症状包括鼻塞、听力障碍、咽痛和吞咽困难，通常伴有颈部淋巴结肿大。从症状出现到诊断的平均持续时间约为2.88个月，从开始治疗到症状缓解的平均时间约为4.90个月。抗结核治疗方案和疗程与症状缓解时间显著相关（分别为r = -0.648，p = 0.003和r = 0.584，p = 0.028）。
这些结果表明，延长抗结核药物疗程可能会加快症状缓解。然而，由于目前缺乏全面数据，需要更多关于患者预后和治疗效果的标准化数据。
