title: A case of direct intracranial extension of tuberculous otitis media.
abstract: We describe a very rare case of tuberculous otitis media (TOM) with direct intracranial extension. The patient was a 55-year-old man who presented to our ENT clinic for evaluation of severe headaches and right-sided otorrhea. A biopsy of granulation tissue obtained from the right external auditory canal demonstrated chronic inflammation that was suggestive of mycobacterial infection. Magnetic resonance imaging of the brain indicated intracranial extension of TOM through a destroyed tegmen mastoideum. After 2 months of antituberculous medication, the headaches and otorrhea were controlled, and the swelling in the external ear canal subsided greatly. Rarely does TOM spread intracranially. In most such cases, intracranial extension of tuberculosis occurs as the result of hematogenous or lymphogenous spread. In rare cases, direct spread through destroyed bone can occur, as it did in our patient.
authors: Department of Otolaryngology-Head and Neck Surgery, St. Mary's Hospital, The Catholic University of Korea, 505 Banpodong, Seochogu, Seoul, Korea 137-040.
authors: Dong-Kee
authors: DK
authors: Kim
authors: Shi-Nae
authors: SN
authors: Park
authors: Kyung-Ho
authors: KH
authors: Park
authors: Sang Won
authors: SW
authors: Yeo
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D002531:Cerebellum / Q000473:pathology; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology; D006097:Granulation Tissue / Q000382:microbiology / Q000473:pathology; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000382:microbiology / Q000473:pathology; D008578:Meninges / Q000473:pathology; D010033:Otitis Media / Q000188:drug therapy / Q000473:pathology*; D016862:Tuberculoma, Intracranial / Q000188:drug therapy / Q000473:pathology*; D014376:Tuberculosis / Q000188:drug therapy / Q000473:pathology*; D014390:Tuberculosis, Meningeal / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents