Rare manifestations of tuberculosis in the head and neck region

Introduction Tuberculosis (TB) primarily affects the lung, but infections can occur in almost all tissues of the body. The main extrapulmonary manifestations in the head and neck region are lymph node and laryngeal tuberculosis. Other otolaryngological manifestations are rare.

Methods Based on 3 cases of extrapulmonary manifestations of TB in the head and neck region, we describe the clinical findings, diagnostics and differential diagnoses.

Results A 36-year-old female patient with TB of the nasal septum presented with nasal obstruction and rhinorrhea. Clinical examination and CT findings raised the suspicion of an inverted papilloma. Right full house FESS and excision of the septal mass were performed with histological and microbiological diagnosis of TB.

TB of the hard palate and the adjacent nasal septum was diagnosed in a 66-year-old patient, who presented to her dentist with a defect of the hard palate. Biopsies were taken and confirmed the diagnosis.

A 21-year-old patient with known open pulmonary tuberculosis developed a TB-associated otitis media and mastoiditis with hearing loss and bloody otorrhea. Ear microscopy showed a perforation of the tympanic membrane with a granulomatous lesion.

Discussion Apart from the more common lymph node and laryngeal tuberculosis, other sites in the ENT region can be affected by TB. Differential diagnoses, apart from malignancies, include inverted papilloma in nasal involvement or cholesteatoma, if the middle ear is affected.

Due to the worldwide migration, an increase in extrapulmonary TB is to be expected. Therefore, it’s necessary to consider TB in the differential diagnosis of various otorhinolaryngical symptoms.

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Publication History

Article published online:
10 June 2020