ABSTRACT
Tuberculosis (TB) is a chronic granulomatous infection caused by Mycobacterium tuberculosis. While TB is predominantly pulmonary, 12–15% of reported cases of TB involve extrapulmonary sites. Rarely the temporal bone may be involved with TB – tuberculous otitis media or tuberculous otomastoiditis. Tuberculous otitis media are even rarer in developed countries and its incidence in the UK is said to be only 0.04% of cases of chronic otitis media. Tuberculous otitis media occur frequently in ears with pre-existing chronic middle ear infection where the organisms enter the middle ear through an existing tympanic membrane perforation. The classical description of tuberculous otitis media is painless otorrhoea, multiple perforations, pale granulations, early severe hearing loss and bone necrosis. While a positive culture for the acid-fast bacillus Mycobacterium tuberculosis confirms the presence of tuberculous otitis media, ear discharge provides a poor yield for positive cultures. This is believed to be due to the low bacterial count in the ear discharge.
