결핵성 중이염에 대한 임상적 고찰

Background and Objectives: The diagnosis of tuberculous otitis media (TOM) is often delayed because of its rarity, the variable presentation, and the lack of highly sensitive and specific diagnostic methods. This delay may results in permanent morbidities such as hearing loss and other complications. This study was performed to evaluate clinical manifestation of TOM and methods of early diagnosis and treatment. Material and Methods: We reviewed the medical records of 26 patients with TOM treated at Presbytreian Medical Center. The diagnosis of TOM was made by AFB smear, culture, histologic analysis and PCR. Results: The results showed the average age of patients is 30.2 years and male outnumbers female. Most patients showed painless intractable otorrhea, mild to moderate hearing loss and perforated drum with granulation. But multiple perforations, facial palsy, and other complications were not observed. Most of the cases were confirmed pathologically by operative specimen. In only medication group, duration of time for diagnosis was relatively shorter and TM closure rate is 50% without surgical intervention. Conclusion: A high index of suspicion for TOM is required patients who do not respond to standard therapy for non tuberculous infections. Appropriate evaluation for TOM includes AFB smear, culture, PCR of otorrhea and operative biopsy. Early diagnosis and treatment of TOM are important to avoid irreversible complications, surgical intervention, and propagation of the disease. (J Clinical Otolaryngol 2007;18:184–189)