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Incidence, Diagnosis and Treatment of Otorhinolaryngological, Head and Neck Tuberculosis: A Prospective Clinical Study
Introduction Tuberculosis is a disease of diversified presentation. It affects almost all organs in the body, and otorhinolaryngological, head and neck involvement is not an exception.
Objective To increase awareness about the different clinical presentations of otorhinolaryngological, head and neck tuberculosis, the techniques employed to diagnose it, and to assess the response to the treatment.
Methods We conducted a prospective study of 114 patients who presented primarily with otorhinolaryngological, head and neck tuberculosis. Routine blood investigations, chest radiographs, the tuberculin test, and sputum examination for the presence of acid-fast bacilli were performed in all cases. Site-specific investigations were performed in relevant cases only. The patients were treated according to the antitubercular treatment (ATT) regimen recommended by the Indian Ministry of Health and Family Welfare's National Tuberculosis Elimination Program (NTEP), and they were followed up clinically two and six months after starting the ATT.
Results Tubercular cervical lymphadenopathy was the most common clinical presentation (85.96%), followed by deep neck abscess (5.27%). Fine-needle aspiration cytology proved to be a reliable tool for the diagnosis of tubercular lymphadenopathy. Improvement at the end of 2 and 6 months of the ATT was observed in 90.35% and 96.50% of the cases respectively.
Conclusion The diagnosis of otorhinolaryngological, head and neck tuberculosis requires a high index of clinical suspicion, and the ATT proved to be very effective in reducing the severity of the disease.
Keywordstuberculosis - Mycobacterium tuberculosis - lymphadenopathy - tuberculin test - antitubercular agents
Received: 29 January 2022
Accepted: 12 September 2022
Article published online:
24 March 2023
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- 1 Bokare B, Mehta K. Otolaryngological Manifestations of Tuberculosis: A Clinical Study. Indian J Otolaryngol Head Neck Surg 2020; •••: 1-8
- 2 Ryan KJ, Ray CG. Medical microbiology. McGraw Hill; 2004. ;4:370.
- 3 Manolidis S, Frenkiel S, Yoskovitch A, Black M. Mycobacterial infections of the head and neck. Otolaryngol Head Neck Surg 1993; 109 (3 Pt 1): 427-433
- 4 Gupta A, Jamwal PS. (2019). Tubercular lesions in otorhinolaryngology. MedPulse International Journal of ENT 12: 40-43 DOI: 10.26611/10161228.
- 5 Lucente FE, Tobias GW, Parisier SC, Som PM. Tuberculous otitis media. Laryngoscope 1978; 88 (7 Pt 1): 1107-1116
- 6 Hoshino T, Miyashita H, Asai Y. Computed tomography of the temporal bone in tuberculous otitis media. J Laryngol Otol 1994; 108 (08) 702-705
- 7 Ng PC, Hiu J, Fok TF, Nelson EA, Cheung KL, Wong W. Isolated congenital tuberculosis otitis in a preterm infant. Acta Paediatr 1995; 84 (08) 955-956
- 8 Mota LA, Leitão PC, dos Anjos Carneiro-Leão AM. ENT Manifestations in Tuberculosis. Tuberculosis (Edinb) 2015
- 9 Kant S, Verma SK. Sanjay. Isolated tonsil tuberculosis. Lung India 2008; 25 (04) 163-164
- 10 Amine C, Amal H, Nawar O, Abdelatif O, Nouredine E. La tuberculose des amygdales palatines. Pan Afr Med J 2010;4(01):
- 11 Gupta KB, Tandon S, Jaswal TS, Singh S. Tuberculosis of tonsil with unusual presentation. Indian J Tuberc 2001; 48 (04) 223-224
- 12 Michael RC, Michael JS. Tuberculosis in otorhinolaryngology: clinical presentation and diagnostic challenges. Int J Otolaryngol 2011; 2011: 686894
- 13 Sriram R, Bhojwani KM. Manifestations of tuberculosis in otorhinolaryngology practice: a retrospective study conducted in a Coastal City of South India. Indian J Otolaryngol Head Neck Surg 2017; 69 (02) 210-215
- 14 Perlman DC, D'Amico R, Salomon N. Mycobacterial infections of the head and neck. Curr Infect Dis Rep 2001; 3 (03) 233-241
- 15 Arora VK, Gupta R. Trends of Extra-pulmonary Tuberculosis under Revised National Tuberculosis Control Programme: A study from South Delhi. 2006
- 16 Pandurang K, Shenoy VS, Bhojwani K, Alva A, Prasad V. et al. (2014) Tuberculosis in the Head and Neck in India: Down but not yet Dead. J Mycobac Dis 4: 148
- 17 Das S, Das D, Bhuyan UT, Saikia N. Head and neck tuberculosis: scenario in a tertiary care hospital of North Eastern India. J Clin Diagn Res 2016; 10 (01) MC04-MC07
- 18 Akkara SA, Singhania A, Akkara AG, Shah A, Adalja M, Chauhan N. A study of manifestations of extrapulmonary tuberculosis in the ENT region. Indian J Otolaryngol Head Neck Surg 2014; 66 (01) 46-50
- 19 Bailey CM, Windle-Taylor PC. Tuberculous laryngitis: a series of 37 patients. Laryngoscope 1981; 91 (01) 93-100
- 20 Soda A, Rubio H, Salazar M, Ganem J, Berlanga D, Sanchez A. Tuberculosis of the larynx: clinical aspects in 19 patients. Laryngoscope 1989; 99 (11) 1147-1150
- 21 Soni NK, Chatterjee P. Laryngeal tuberculosis. Indian J Otolaryngol 1978; 30 (03) 115-117
- 22 Levenson MJ, Ingerman M, Grimes C, Robbett WF. Laryngeal tuberculosis: review of twenty cases. Laryngoscope 1984; 94 (08) 1094-1097
- 23 Ricciardiello F, Martufi S, Cardone M, Cavaliere M, D'Errico P, Iengo M. Otorhinolaryngology-related tuberculosis. Acta Otorhinolaryngol Ital 2006; 26 (01) 38-42
- 24 Moon WK, Han MH, Chang KH. et al. CT and MR imaging of head and neck tuberculosis. Radiographics 1997; 17 (02) 391-402
- 25 Kamal MS, Hoque MH, Chowdhury FR, Farzana R. Cervical tuberculous lymphadenitis: clinico-demographic profiles of patients in a secondary level hospital of Bangladesh. Pak J Med Sci 2016; 32 (03) 608-612
- 26 Sachdeva K, Shrivastava T. CBNAAT: a boon for early diagnosis of tuberculosis-head and neck. Indian J Otolaryngol Head Neck Surg 2018; 70 (04) 572-577