Zhu Xiang-Song, Xu Hai-Yan, Dong Yan-Bo, Liu Yu-He, Gong Shu-Sheng, Li Wan-Xin
Department of Otorhinolaryngology, Traditional Chinese Medicine Hospital of Anshun City, Guizhou, China.
Center of Otorhinolaryngology-Head & Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Ear Nose Throat J. 2024 Dec 10:1455613241304900. doi: 10.1177/01455613241304900.
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. 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. 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 . 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. 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.
鼻咽部与耳乳突部结核并存是一种极为罕见的临床病症。截至目前，英文文献中仅报道过2例此类病例，中文文献中另有2例相关报道。本文旨在总结我们处理该病症的经验并回顾相关文献。我们对2022年6月至2024年5月期间在两家三级医疗机构接受治疗的鼻咽部与耳乳突部结核并存的病例进行了回顾性研究。从病例记录中检索数据并进行分析。总共纳入了3例病例（2例男性患者来自前一家机构，1例女性患者来自后一家机构）。1例为双侧病变，另外2例为单侧病变。他们的年龄在23岁至49岁之间（平均年龄和中位数年龄分别为36.3岁和37岁）。临床表现包括耳闷、听力下降、耳漏、面瘫和耳痛。经过仔细的诊断检查，所有患者均发现了耳乳突部和鼻咽部病变。制定了手术方案，所有病例两个部位病变的组织病理学检查均提示为结核，而聚合酶链反应（PCR）证实了结核杆菌的存在。所有患者均接受了6个月的抗结核治疗。中位随访时间为10个月。未记录到复发情况。本文还呈现了所有7例此类病例的总结。鼻咽部与耳乳突部结核并存极为罕见。手术或手术活检对治疗和诊断均很重要。经组织病理学和PCR确诊为结核后，抗结核治疗对预防复发非常重要。症状通常可以改善，尽管情况并非总是乐观。
