THE GREAT MIMICKER IN THE MIDDLE EAR: A CASE SERIES OF TUBERCULAR OTITIS MEDIA IN THREE DISTINCT PRESENTATIONS

doi:10.61336/JSR/26-4-9

Journal of Surgical Radiology

2026, Volume 5, Issue 4 : 52-58 doi: 10.61336/JSR/26-4-9

Research Article

THE GREAT MIMICKER IN THE MIDDLE EAR: A CASE SERIES OF TUBERCULAR OTITIS MEDIA IN THREE DISTINCT PRESENTATIONS

AvinashKumar

Garima Sinha

Shreya Jain

Mansi Sharma

⁴

Meetali Lakra

⁵

Associate Professor, Dept. of Otorhinolaryngology – Head and Neck Surgery Saraswathi Institute of Medical Sciences (SIMS) Anwarpur ,Hapur, U.P.

Assistant Professor, Dept. of Anaesthesia and Critical Care, Government Institute of Medical Sciences ( GIMS ) Greater Noida , U.P.

Senior Resident , Dept. of Otorhinolaryngology – Head and Neck Surgery Saraswathi Institute of Medical Sciences (SIMS) Anwarpur ,Hapur, U.P.

⁴

Assistant Professor, Dept. of Otorhinolaryngology – Head and Neck Surgery Saraswathi Institute of Medical Sciences (SIMS) Anwarpur ,Hapur, U.P.

⁵

MBBS Final year student Saraswathi Institute of Medical Sciences (SIMS), Anwarpur, Hapur, Uttar Pradesh, India

DOI : 10.61336/JSR/26-4-9

Received

March 15, 2026

Revised

March 22, 2026

Accepted

April 10, 2026

Published

April 17, 2026

Abstract

Extrapulmonary tuberculosis contributes to 15% the total tuberculosis cases and out of which tubercular otitis media is a rare presentation. We have described three cases related to TOM that were diagnosed and treated for the same in our instituteThe aim of this study is to see tuberculosis as a differential diagnosis when usual treatment fails to work and also the difficulty faced in diagnosing it. All the three cases presented with ear discharge and hearing loss as common presentation, one had aural polyp and other one had mastoiditis. All of the cases were confirmed as cases of tubercular otitis media with help of Histopathologyand were started on ATT therapy to which all of them responded well and they were free of the disease. Early diagnosis and treatment are important because late diagnosis may lead to complications such as Facial palsy.

Keywords

Tubercular otitis media

CSOM

Mastoiditis

Postauricular Fistula

Aural polyp

Conclusion

This case series highlight the various presentation of tubercular otitis media and various difficulties faced in diagnosing the conditions.

Appropriate clinical suspicious play important role in early diagnosing of TOM and also help in preventing complications. In our case series we also discussed the newer diagnostic tool that helped in managing the patient well. A combined approach involving middle ear surgery along with Anti tubercular therapy led to favorable outcome.

The findings of this study emphasize the need to consider tuberculosis in patients with chronic otitis media that fails to improve with standard antibacterial treatment, especially in regions where tuberculosis is common. These patients frequently exhibit significant conductive hearing loss and a higher risk of complications originating from the ear.

Diagnosis can be challenging due to the frequent presence of mixed infections; however, AFB staining and histopathological examination of tissue from the middle ear remain reliable methods for confirmation. A combination of anti-tubercular therapy (ATT) and surgical intervention has been shown to provide effective disease control, even in more advanced stages

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