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What is Most common type of hearing loss in TB otitis media and explain in detail?
Ans. (a) Conductive hearing lossRef: Dhingra's ENT 5th ed. / 83Clinical features of Tubercular otitis media:# Painless foul smelling ear discharge: very characteristic finding.# Perforation: multiple perforations usually 2-3 on pars tensa is classical sign of disease.# Hearing loss: There is a severe hearing loss , out of proportion to symptoms . Mostly conductive, it may be SNHL if labyrinth is involved.# Facial paralysis* In the presence of secondary pyogenic infection, tubercular otitis media may be indistinguishable from chronic suppurative otitis media. Culture of ear discharge for tubercle bacilli, histopathological examination of granulations and other evidence of tuberculosis in the body help to confirm the diagnosis.Treatment# Systemic antitubercular therapy as being carried for primary focus.# Local treatment in the form of aural toilet and control of secondary pyogenic infection. Mastoid surgery is indicated for complications. Healing is delayed in tuberculous cases. Wound break-down and fistula formation are common.