结核性中耳炎患者5例临床分析  

Clinical features of tuberculous otitis media:An analysis of five cases

作　　者：任韶康 吴静[1] 郑乾佑 朱秋阳 张晓雯[1] 李慎玲[1] 付涛[1] REN Shaokang;WU Jing;ZHENG Qianyou;ZHU Qiuyang;ZHANG Xiaowen;LI Shenling;FU Tao(Department of Otorhinolaryngology Head and Neck Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266035,China)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266035

出　　处：《精准医学杂志》2025年第1期77-79,共3页Journal of Precision Medicine

摘　　要：目的探讨结核性中耳炎的临床特征,以便进行早期诊断和鉴别,从而防止严重并发症的发生。方法回顾性分析2015年4月—2023年6月于我院5例确诊为结核性中耳炎患者的临床资料,对其临床特征、诊断和患者预后进行总结。结果患者均存在耳流脓、鼓膜穿孔、不同程度的听力下降等症状,其中1例患者伴有周围性面瘫。1例患者通过术后中耳肉芽组织病理学检查确诊,4例患者通过耳分泌物结核杆菌基因检测确诊。2例患者进行了乳突根治术联合抗结核治疗,另外3例在确诊后进行了单纯抗结核治疗。随访1年5例患者均鼓膜愈合,获得干耳,均再无复发。结论结核性中耳炎临床特征不典型,易误诊为化脓性中耳炎,组织病理学检查和结核杆菌基因检测能够确诊。抗结核药物治疗是治疗结核性中耳炎基础,同时辅以手术治疗能有效根除潜在病灶,以期达到治愈效果。Objective To investigate the clinical features of tuberculous otitis media,to facilitate early diagnosis and differential diagnosis,and to prevent severe complications.Methods A retrospective analysis was performed for the clinical data of five patients who were diagnosed with tuberculous otitis media in our hospital from April 2015 to June 2023,and their clinical features,diagnosis,and prognosis were summarized.Results All five patients had the symptoms of purulent ear discharge,tympanic membrane perforation,and varying degrees of hearing loss,and one patient was comorbid with peripheral facial paralysis.One patient was diagnosed based on postoperative middle ear granulation histopathology,and four patients were diagnosed by genetic testing of Mycobacterium tuberculosis in ear secretions.As for treatment,two patients underwent radical mastoidectomy combined with anti-tuberculosis therapy,and the other three patients received anti-tuberculosis therapy alone after diagnosis.After one year of follow-up,all five patients achieved eardrum healing and dry ear without recurrence.Conclusion Tuberculous otitis media has atypical clinical features and may easily be misdiagnosed as suppurative otitis media,and histopathological examination and Mycobacterium tuberculosis genetic testing can help to make a confirmed diagnosis.Anti-tuberculosis medication is fundamental in the treatment of tuberculous otitis media,while surgical treatment can effectively eradicate potential lesions,so as to achieve cure in clinical practice.

关 键 词：中耳炎 结核 临床特征 诊断 治疗结果 回顾性研究 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]