Abstract：
OBJECTIVE: Review of the scientific literature dedicated to clinical data and diagnosis modalities for aural tuberculosis published since the start of the 21st century.
METHODS: Search of the Medline, Cochrane and Embase databases for the period 2000-2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting clinical data and diagnosis for aural tuberculosis of articles by two authors. Analysis performed according to SWiM guidelines. Extraction of data on pre-established files documenting clinical and diagnostic data.
RESULTS: In total, 173 articles: 163 case reports (228 patients) and 10 cohorts (177 patients) from 49 countries were analyzed. Female/male sex ratio was 1.05, with ages ranging from less than 1 month to 87 years. Tuberculosis involved another site in 35.1% of cases. Aural involvement was bilateral in 19.7% of cases. Clinical presentation corresponded to otitis media (prior antibiotic treatment and auricular surgery in 41.4% and 10.1% of cases, respectively) without any pathognomonic symptoms or signs. Associated severe locoregional complications were seen in 32% of cases, with 23.2% and 13% incidence of peripheral facial palsy and severe intracranial complications, respectively. Time to diagnosis ranged from less than 1 month to 384 months, and was longer than 12 months in 26.5% of case reports, without significant correlation (P=0.29) with severe revelatory locoregional complications. Incidence of Mycobacterium tuberculosis detection ranged from 33.4% of documented cases in auricular secretions to 64.6% in polyps, granulomas, and/or biopsies. In the case reports, diagnosis with certainty was done in 58.3% of cases, while it was based on involvement of another site and on indirect criteria or positive clinical progression after treatment in the other 10.1% and 31.6%, respectively.
CONCLUSIONS: Aural tuberculous must always be considered in case of unfavorable progression of otitis. Definitive diagnosis is based on multiple auricular sample sites, polymerase chain reaction, and γ interferon blood assay.
METHODS: Search of the Medline, Cochrane and Embase databases for the period 2000-2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting clinical data and diagnosis for aural tuberculosis of articles by two authors. Analysis performed according to SWiM guidelines. Extraction of data on pre-established files documenting clinical and diagnostic data.
RESULTS: In total, 173 articles: 163 case reports (228 patients) and 10 cohorts (177 patients) from 49 countries were analyzed. Female/male sex ratio was 1.05, with ages ranging from less than 1 month to 87 years. Tuberculosis involved another site in 35.1% of cases. Aural involvement was bilateral in 19.7% of cases. Clinical presentation corresponded to otitis media (prior antibiotic treatment and auricular surgery in 41.4% and 10.1% of cases, respectively) without any pathognomonic symptoms or signs. Associated severe locoregional complications were seen in 32% of cases, with 23.2% and 13% incidence of peripheral facial palsy and severe intracranial complications, respectively. Time to diagnosis ranged from less than 1 month to 384 months, and was longer than 12 months in 26.5% of case reports, without significant correlation (P=0.29) with severe revelatory locoregional complications. Incidence of Mycobacterium tuberculosis detection ranged from 33.4% of documented cases in auricular secretions to 64.6% in polyps, granulomas, and/or biopsies. In the case reports, diagnosis with certainty was done in 58.3% of cases, while it was based on involvement of another site and on indirect criteria or positive clinical progression after treatment in the other 10.1% and 31.6%, respectively.
CONCLUSIONS: Aural tuberculous must always be considered in case of unfavorable progression of otitis. Definitive diagnosis is based on multiple auricular sample sites, polymerase chain reaction, and γ interferon blood assay.
摘要：
目的：回顾21世纪初以来发表的关于耳部结核病临床数据和诊断模式的科学文献。
方法：搜索Medline，2000-2020年期间的Cochrane和Embase数据库。英语文章的选择，法语和西班牙语致力于临床病例和系列文献，记录两位作者的听觉结核病的临床数据和诊断。根据SWiM指南进行分析。在记录临床和诊断数据的预先建立的文件中提取数据。
结果：总计，173篇文章：分析了来自49个国家的163例病例报告（228例患者）和10个队列（177例患者）。男女性别比例为1.05，年龄从不到1个月到87岁不等。35.1%的病例涉及另一个部位的结核病。在19.7％的病例中，听觉受累是双边的。临床表现与中耳炎相对应（在41.4％和10.1％的病例中，先前的抗生素治疗和耳廓手术，分别)没有任何病理症状或体征。在32％的病例中看到了相关的严重局部并发症，周围性面神经麻痹和严重颅内并发症发生率分别为23.2%和13%，分别。诊断时间从不到1个月到384个月不等，在26.5%的病例报告中超过12个月，与严重的启示性局部并发症没有显着相关性（P=0.29）。结核分枝杆菌检测的发生率从耳廓分泌物中的记录病例的33.4％到息肉中的64.6％，肉芽肿,和/或活检。在案例报告中，58.3%的病例进行了确定性诊断，虽然它是基于另一个部位的参与和间接标准或其他10.1％和31.6％的治疗后的积极临床进展，分别。
结论：耳炎进展不利时，必须始终考虑耳部结核性。最终诊断是基于多个耳廓样本部位，聚合酶链反应，和γ干扰素血液检测。
方法：搜索Medline，2000-2020年期间的Cochrane和Embase数据库。英语文章的选择，法语和西班牙语致力于临床病例和系列文献，记录两位作者的听觉结核病的临床数据和诊断。根据SWiM指南进行分析。在记录临床和诊断数据的预先建立的文件中提取数据。
结果：总计，173篇文章：分析了来自49个国家的163例病例报告（228例患者）和10个队列（177例患者）。男女性别比例为1.05，年龄从不到1个月到87岁不等。35.1%的病例涉及另一个部位的结核病。在19.7％的病例中，听觉受累是双边的。临床表现与中耳炎相对应（在41.4％和10.1％的病例中，先前的抗生素治疗和耳廓手术，分别)没有任何病理症状或体征。在32％的病例中看到了相关的严重局部并发症，周围性面神经麻痹和严重颅内并发症发生率分别为23.2%和13%，分别。诊断时间从不到1个月到384个月不等，在26.5%的病例报告中超过12个月，与严重的启示性局部并发症没有显着相关性（P=0.29）。结核分枝杆菌检测的发生率从耳廓分泌物中的记录病例的33.4％到息肉中的64.6％，肉芽肿,和/或活检。在案例报告中，58.3%的病例进行了确定性诊断，虽然它是基于另一个部位的参与和间接标准或其他10.1％和31.6％的治疗后的积极临床进展，分别。
结论：耳炎进展不利时，必须始终考虑耳部结核性。最终诊断是基于多个耳廓样本部位，聚合酶链反应，和γ干扰素血液检测。
