Tuberculosis in the middle ear: 5 case reports.

Five cases of tuberculosis otitis media are reported. The clinical picture and the hazards of diagnosis are discussed. Although not a common cause of chronic otitis media, tuberculosis of the middle ear cleft is an entity one should recognize especially when a chronic suppurative ear disease does not respond to the usual treatment. The signs and symptoms are non-specific. Altering features include racial predisposition, contact or personal history of past or present tuberculosis, chronicity, development of a facial palsy and the pale granulation tissue found at the operation.

Congenital middle ear malformations.

After a profound review of normal embryology, a systematical and topographical classification of congenital middle ear malformations in general and of meatal atresia in particular is proposed; the classification of congenital aural atresia is essentially based on the recognition of two types according to the course of the facial nerve in its third segment: in type I, a normal topography of the facial nerve is found and consequently, the middle ear anomalies are rather minimal; in type II, an antero-superior displacement of the facial nerve in its third segment is recognized and the middle ear malformations are considerable worse. In this report, also attention is paid to syndromal nosology and its genetic aspects. In view of functional surgical; reconstruction, the technique of allograft canal surgery, similar to our combined approach tympanoplasty technique, is described in detail and compared with other classical techniques. Preoperative as well as postoperative problems and complications are extensively discussed. The excellent results of our technique are proposed even after 25 years of experience. An overview of cosmetic surgery techniques is given and also alternative techniques with implantable auditory prosthetic materials are summarized.