Four Cases of Sinonasal Tuberculosis

Park, Jeong Hyeog; Lee, Bong Jae

Abstract

Tuberculosis of the nose and paranasal sinuses is so rare that only 43 cases of primary tuberculosis of paranasal sinuses had been reported in literature worldwide. Recently, the authors have experienced 4 cases of tuberculosis developed in the nose and/or paranasal sinuses. We reviewed medical records, radiological and histopathological findings of these cases to find out the clinical features and treatment outcome. Chief complaints of patients were cheek swelling or nasal obstruction. One case had inactive pulmonary tuberculosis on the chest X-ray film, whereas the others had no evidence of previous tuberculosis infection. All cases revealed abnormalities in the maxillary sinuses. One case was diagnosed with tuberculosis after a tissue biopsy from the inferior turbinate, and the others were diagnosed with tissue biopsies from the maxillary sinus mucosa taken during endoscopic sinus surgery or Caldwell-Luc's operation. Histopathologic examinations revealed granulommatous inflammation and caseation necrosis. All cases showed positive reactions in acid fast bacteria (AFB) staining or culture for AFB. Patients were managed with periodic nasal dressing and antituberculous chemotherapy over 9 months and they became free of symptoms.