Tuberculous otitis media in adults is usually secondary to tuberculosis elsewhere in the body.
The diagnosis rests on the painless onset of a thin mucopurulent discharge, together with marked deafness, rather than on laboratory methods. The only non-tubercular cases in which this is likely to occur are those in which there is an old-standing perforation of the tympanic membrane.
Multiple perforations of the membrana tympani occur in about one-third of the cases.
The chances of recovery from the local condition are fair.
Secondary infection by pyogenic organisms completely changes the clinical picture and renders the outlook more serious. When this takes place there is a marked tendency to luxuriant proliferation of granulation tissue.
The presence of a tuberculous otitis media indicates a severe infection, and justifies a grave prognosis of the general condition2.
Treatment should be confined to simple cleansing of the meatus, and the use of mild antiseptics. It is suggested that zinc ionization might give good results in a series of cases. Treatment of the lung infection is of major importance.
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Wilson, T.G. Tuberculosis of the middle ear in the adult. Ir J Med Sci 7, 126–129 (1932). https://doi.org/10.1007/BF02953296