Tuberculosis is a potentially harmful infectious disease. Head and neck tuberculosis (HNTB) used to describe the tuberculosis of head and neck areas such as oral cavity, oropharynx, pharynx, larynx, nasal cavity, ears,...
Tuberculosis is a potentially harmful infectious disease. Head and neck tuberculosis (HNTB) used to describe the tuberculosis of head and neck areas such as oral cavity, oropharynx, pharynx, larynx, nasal cavity, ears, paranasal sinuses salivary glands, neck spaces and lymph nodes. The most common HNTB is cervical lymphadenopathy also known as scrofula.
What Causes HNTB?
Tuberculosis spreads through inhalation of bacteria. A person with tuberculosis infection can infect 10-15 other people per year. Tuberculosis bacteria spread via infected aerosols.
People with low immunity, diabetes or HIV are more prone to the risk.
TB Head and Neck
Tuberculosis of the head can involve the cervical lymph nodes, larynx, temporal bone, para nasal sinus, eye , pharynx,salivary gland,thyroid gland and skull base and brain.
The tuberculosis of cervical lymph also known as SCROFULA and historically as king’s evil.
As a trusted diagnostic centre, we want to inform on the importance of early detection of tuberculosis in these areas.
Most commonly Cervical lymphadenopathy (91%), Laryngeal TB (4.3%), tuberculosis otitis media (1.4%), nasal TB (1.4%), and oral tuberculosis (1.4%). While extra pulmonary tuberculosis cases as per WHO survey is 20.6%.
Tuberculosis can be detected by looking at these symptoms according to the region it involves-
TB Neck
Chronic, painless mass in the neck which is persistent in nature and usually grows with time. This mass or nodules are known as cold abscess.
Also Tb neck is accompanied with fever, chills and weight loss.
Sometimes overlying skin over the mass or lump adhered to the mass and may rupture with the release of pus & an open wound is formed.
Most commonly it occurs in the third decade of life.
Person may complain of coughing with expectoration, fever and discharging sinus.
Laryngeal Tuberculosis
Laryngeal tuberculosis usually occurs in the larynx. Larynx is also known as voice box. It is in the neck above the windpipe/trachea.
Tuberculosis of the larynx commonly occurs from TB in lungs from contaminated sputum or via blood.
Symptoms of TB in the larynx include- hoarseness in voice, difficulty and pain in swallowing, ulceration on the site of involvement.
All these individuals are sputum positive.
Tuberculosis Otitis Media
Tuberculosis in ear and mastoid is very rare. It commonly occurs due to secondary transmission from other organs.
It commonly spreads through hematogenous spread.
Symptoms of otitis tuberculosis are- Ear discharge, in severe cases hearing loss and paralysis of face may occur.
It can be diagnosed by the ear discharge culture test.
Nasal Tuberculosis
Tuberculosis involvement of nose, nasopharynx and Para nasal sinus is very rare in comparison to pulmonary TB.
Symptoms of nasal tuberculosis are- persistent nasal discharge or nasal obstruction in case of polypoidal mass in nasal cavity and nose bleeding.
Recurrent nasal polyps, septal perforation, cleft of nasal ala or facial abscess may be present.
It can be tested by nasal swab test, endoscopy and nasal endoscopy.
Oral Tuberculosis
Tuberculosis is a chronic infection that can spread through sputum or hematogenously to different body parts and can involve maxilla and mandible.
Tuberculosis seen in younger patients which is associated with enlarged cervical lymph nodes.
The tongue is the most commonly affected site in various forms such as ulcers, nodules, fissures, plaques or vesicles.
The salivary gland, tonsils and uvula are also involved. Buccal mucosa, gingival, lips, palate, palatine tonsils and floor of the mouth can also be affected.
Tuberculosis of the oral cavity is very rare but infection may cause difficulty in mouth opening, recurrent painless ulcers on the buccal mucosa. Oral hygiene of the infected person is poor.
Oral tuberculosis can be evaluated by biopsy, AFB smear microscopy, bacterial culture test and other TB tests.
All these symptoms can be mistaken for less severe conditions. Hence screening of the disease is necessary for accurate diagnosis.
The Diagnostic Process -
Diagnosis of tuberculosis of head and neck is a multistep process-
Clinical evaluation-
A specialist doctor evaluates the patient’s symptoms , medical history and physical examination. By which doctor can predict the possibility of tuberculosis.
Imaging studies-
Important diagnostic methods to detect the tuberculosis are-
- Chest X-ray
CT scans can assess the abnormalities in head and neck, such as enlarged lymph nodes or lesions in case of swelling or lump in head and neck region
- MRI head and neck
Biopsy- It is the gold standard method for confirmation of any disease. Tissue sample is taken from the affected area.
Molecular Testing
PCR used to detect the genetic material of tuberculosis bacteria
Ganesh Diagnostic’s Commitment to Tuberculosis Diagnosis-
As a leading diagnostic centre, we are committed to use of advanced technology and a team of experienced pathologists and radiologists.
If you or your loved one are experiencing persistent symptoms in the head and neck region, don’t hesitate to seek medical attention.
Ganesh diagnostic centre is here to guide you in your diagnostic journey.
We offer a wide range of diagnostic tests, providing you with the care and peace of your mind you deserve.
The rates of scans are reasonably priced. Ganesh Diagnostic and Imaging Centre also offer FLAT 50% OFF on many tests.
Tests conducted at Ganesh Diagnostic & Imaging Center are as follows:
The doctor will examine you for heart rate, fever, mental status, and stiff neck.
- AFB test
- Culture Mycobacterium Atypical Non-Tuberculous Mycobacterium-NTM
- X-ray chest
- Ultrasound
- CT
- HRCT
- CECT
- MRI
- Polymerase chain reaction (PCR) for tuberculosis
- HAINS Mycobacterium Tuberculosis First & Second Line Drug Resistance Profile
- Smear Test
- Mantoux test
- FNAC
- Biopsy
We are based in Delhi NCR Region, and our branches are in the following regions:
Yamuna Vihar, Mangol Puri, Budh Vihar, Model Town, Hari Nagar, Nagloi, Rohini
Refrences
- ENT manifestations of tuberculosis: an important aspect of ENT practice https://www.panafrican-med-journal.com/content/article/36/295/full
- Head and Neck Tuberculosis: Scenario in a Tertiary Care Hospital of North Eastern India https://pdfs.semanticscholar.org/f102/51674c591c7b3f805b0df66e775e8839e12f.pdf
- Harrison’s principle of internalmedicine, Jamson,Fauci, Kasper,Hauser,Longo,Loscalzo: 20 edition
- Cervical Lymphadenopathy What Is It, Causes, Workup, Treatment, and More https://www.osmosis.org/answers/cervical-lymphadenopathy
