结核性中耳炎的诊断经验：一种罕见且被认识到的肺外结核
Diagnostic experience of tuberculosis otitis media, a rare recognized extrapulmonary tuberculosis.
文献信息
| PMID | 42983344 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Chenyu Chen |
| 作者单位 | ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China. |
| 期刊 | BMC infectious diseases |
| SCI 分区 | Q2 |
| IF | 3.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 肺外结核（EPTB）在诊断和治疗方面仍然是一个挑战。结核性中耳炎（TBOM）是EPTB的一种罕见且具有挑战性的形式，因其表现多样且发病率低。TBOM的早期及时诊断对治疗至关重要。在本研究中，我们试图更好地了解TBOM的多种临床表现和影像学诊断信息。
方法： 本研究对我科2019年9月至2025年6月期间治疗的TBOM病例进行了回顾性分析。总结其临床特征、诊断和治疗。所有参与者均接受了颞骨高分辨率计算机断层扫描，并使用四个部分评估中耳状态：中鼓室、上鼓室、鼓窦和乳突气房。
结果： 研究纳入12例TBOM病例，其中女性10例，男性2例，中位年龄为33岁。TBOM主要表现为耳漏、听力下降和耳鸣症状。炎症也影响未受累耳，与普通中耳炎患者相比，TBOM在患侧显示出更高的特异性。尤其是未受累耳在TBOM中几乎总是通气良好。所有病例均完成了中耳手术和抗结核治疗（ATT）。平均随访时间为10个月。未观察到TBOM复发病例。
结论： EPTB需要高度的临床怀疑和多学科方法进行诊断和治疗。我们强调，对于高度怀疑TBOM的病例，特征性影像学表现和临床症状应引起高度重视。
英文摘要
PURPOSE: Extrapulmonary tuberculosis (EPTB) remains a challenge in the diagnosis and treatment. Tuberculosis otitis media (TBOM) is a rare and challenging form of EPTB due to its varied presentation and rare incidence. Early and timely diagnosis of TBOM is crucial for treatment. In this study, we sought to gain a better understanding of the varied clinical presentations and imaging diagnostic information for TBOM.
METHODS: This was a retrospective review of TBOM cases that were treated at our department, between September 2019 and June 2025. Summarizing their clinical characteristics, diagnosis, and treatment. All participants underwent the temporal bone High-Resolution Computed Tomography, and middle ear status was assessed using four sections: mesotympanum, attic, antrum and mastoid air cells.
RESULTS: Twelve cases of TBOM, 10 female and 2 male patients, median age was 33 years, were included in the study. TBOM mainly presents with symptoms of otorrhea, hearing loss, and tinnitus. Inflammation also affects the unaffected ear, with TBOM showing greater specificity on the affected side compared with patients with common otitis media. The unaffected ear in particular almost always provides good ventilation in TBOM. Middle ear surgery and Anti-tubercular treatment (ATT) were completed in all cases. The average follow-up was 10 months. No cases of TBOM relapses were observed.
CONCLUSION: EPTB requires high clinical suspicion and a multidisciplinary approach for diagnosis and treatment. We highlight that characteristic imaging manifestations and clinical symptoms should be attracted high attention for cases with high suspicion of TBOM.