中国耳鼻咽喉颅底外科杂志2025，Vol.31Issue(6)：33-36,4.DOI:10.11798/j.issn.1007-1520.202525090
婴幼儿结核性中耳炎临床治疗分析
Clinical treatment analysis of infantile tuberculous otitis media
赵兴贺 1尹德佩 1窦训武 1樊明月 1张海港1
作者信息
- 1. 苏州大学附属儿童医院 耳鼻咽喉科,江苏苏州 215003
- 折叠
摘要
Abstract
Objective To investigate the clinical manifestations,diagnostic strategies and clinical treatment of infantile tuberculous otitis media(TOM).Methods It was retrospectively analyzed for the clinical data of 3 children with TOM admitted to the Children's Hospital Affiliated to Soochow University from April 2021 to January 2025.All 3 children had repeated manifestations of otorrhea and granulation tissue hyperplasia in the external auditory canal before the operation,who had manifestations of pulmonary tuberculosis infection to varying degrees.The preoperative ear discharge culture results of the two children indicated positive for methicillin-resistant Staphylococcus aureus.Linezolid was selected for anti-infection treatment of the two children based on the drug sensitivity test.The preoperative mastoid CT examination showed mastoiditis with partial destruction of the mastoid bone.The preoperative MRI indicated mass-like signal shadows in the mastoid and external auditory canal,which showed long T1 and long T2,and fat-suppressed T2 signal shadows.Modified radical mastoidectomy and external auditory canal granulation tissue removal surgery were performed at an appropriate time,and the use of antibiotics was adjusted according to the results of bacteriological examination.Results During the operation,granulomatous tissue hyperplasia in the mastoid and tympanic cavities,mucosal edema,accompanied by pus was observed in 3 cases,who had the intact ossicular chain upon examination.Postoperative pathology revealed chronic granulomatous inflammation accompanied by caseous necrosis.After operation,3 patients continued to receive systemic antituberculosis drug treatment.Among them,1 case unfortunately died due to bronchoscopy anesthesia.The other 2 children were stable after treatment with anti-tuberculosis drugs,no recurrent low fever,dry external ear canal without pus.They are still under follow-up observation at present.Conclusions TOM in infants and young children occurs relatively insidiously,who is often complicated by multi-drug resistant bacterial infections with poor response to traditional antibiotic treatment.It is necessary to complete mastoid CT and MRI,and promptly perform mastoidectomy to clear the lesion.After the operation,a clear diagnosis should be made based on bacteriological and pathological examinations.Systemic anti-tuberculosis drugs should be combined with treatment.Regular postoperative follow-up should be conducted to monitor the recovery of mastoid lesions.关键词
结核性中耳炎/婴幼儿/临床治疗Key words
Tuberculous otitis media/Infants/Clinical treatment分类
医药卫生引用本文复制引用
赵兴贺,尹德佩,窦训武,樊明月,张海港..婴幼儿结核性中耳炎临床治疗分析[J].中国耳鼻咽喉颅底外科杂志,2025,31(6):33-36,4.
