經耳咽管感染之結核性中耳炎－病例報告

Trans-Eustachian Tube Infected Tuberculous Otitis Media - Case Report

鍾易晉(Yih-Jinn Jong) ； 林凱南(Kai-Nan Lin)

《中華民國耳鼻喉科醫學會雜誌》 29卷1期 (1994/02) Pp. 32-36

https://doi.org/10.6286/1994.29.1.32

摘要

結核性中耳炎在抗結核藥物發達的今日，已不多見。在鼻填塞後發生之結核性中耳炎，到目前為止，並無文獻報告。本科於1992年1月間曾診治一名30歲女性病患，主訴3個月前經過鼻填塞後，發生右側耳鳴、中耳積液，隨後有耳漏現象。患者接受中耳探查手術，病理報告為結核性中耳炎。病人於是接受1年之抗結核藥物治療，嗣後再進行鼓膜與聽小骨重建手術，現仍於門診追蹤。

關鍵字

結核性中耳炎 ； 鼻填塞

並列摘要

Tuberculosis of the middle ear is currently a rare disease. As most physic-cians are unfamiliar with the typical presenting features, the diagnosis is frequently made too late, which may result in complications such as irreversible hear-ing loss and facial nerve paralysis. In this paper we report a case of nasal-packing-induced tuberculous otitis media. A 30-year-old woman presented with tinnitus of the right ear after nasal packing because of postoperative nosebleed. Effusion of the right middle ear developed later, which was treated by repeated myringocentesis. Crescent perforation of the tympanic membrane with persistent otorrhea happened after this procedure. We performed right exploratory tympanotomy and found that the middle ear cavity and mastoid cavity were filled with pale granu-lation tissue. Ossicular chain destruction was also found. Pathological examination of the surgical specimen revealed tubercu-lous infection. After one year of anti-TB chemotherapy, tympanoplasty was performed. Fibrotic change of the middle ear mucosa was found, which showed no more tuberculous change under pathologic examination.

並列關鍵字

tuberculous otits media ； nasal packing