Tuberculous otitis media: a series of 22 patients.

A series of 22 cases of tuberculous otitis media is reviewed to assess the diagnostic features of the disease. Significant clinical features are the presence of abundant pale granulations, an unexpectedly severe hearing loss, facial paralysis, the presence of normal mastoid cellular develpment and a past or family history of tuberculosis of any site. The otoscopic appearances of the tympanic membrane, and the symptom of painless otorrhea are not considered suspicious features. Histological examination of operative material was the diagnostic procedure in 20/22 cases, thus underlining the difficulty of diagnosis in a non-tuberculous general population. Treatment with antituberculous chemotherapy and surgery gives good results and recent indications are that tympanoplastic surgery may be useful.