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Primary Spheno-Petro-Clival Tuberculosis

  • Hitesh VermaEmail author
  • Smriti Panda
  • Kapil Sikka
  • David Victor Kumar Irugu
  • Alok Thakar
Original Article

Abstract

The increase awareness and advent of anti-tuberculosis therapy led to decline in tuberculosis. Now a resurgence of tuberculosis is with immunosuppression and with resistant strains. The detection rate of extrapulmonary is increased with the advent of newer modalities of detection, imaging, and better testing. This case series documents our experience with seven cases of primary spheno-petro-clival lesion and details of the clinical and radiological presentations of these patients. Intraoperative obtained tissue was send for histopathological and microbiological evaluation. The most common symptoms were headache and nasal discharge. The final diagnosis of spheno-petro-clival tuberculosis was confirmed in all cases with histopathology and by culture post-operatively. Skull base tuberculosis is relative rare entity in past because of late occurrence of specific symptom, incomplete radiological evaluation and it may present as neck swelling by travelling through various neck spaces. (1) Tubercular infection should be considered as differential in skull base lesion as pickup rate is increasing with advancement in technology. (2) Two of our cases had retropharyngeal abscess have focus in skull base bone. The skull base, hence, may be one of foci in undetermined sites of tuberculous infections and should be searched for.

Keywords

Tuberculosis Spheno-petro-clival region Skull base Infection Paranasal sinuses 

Notes

Acknowledgements

We are thankful to Director and Head of Department for allowing us to use data.

Author Contribution

Dr Hitesh Verma was involved in designing, collection of data and drafting of article. Dr Smriti Panda, Dr Kapil Sikka and Dr David Victor Kumar Irugu were contributes in analysing and interpretation of data. Dr Alok Thakar was substantial contributions in conception, design, and final approval of article.

Compliance with Ethical Standards

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

The study is based on radiological finding and patient case file.

References

  1. 1.
    Miziara D (2005) Tuberculosis affecting the oral cavity in Brazilian HIV-infected patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:179–182CrossRefGoogle Scholar
  2. 2.
    Lee DK, Cho K-T, Im S-H, Hong S-K (2007) Craniovertebral junction tuberculosis with atlantoaxial dislocation: a case report and review of the literature. J Korean Neurosurg Soc 42:406–409CrossRefGoogle Scholar
  3. 3.
    Suslu HT, Gulec L, Bozbua M (2008) Frontal bone and epidural tuberculosis. Turkish Neurosurg 18(1):78–81Google Scholar
  4. 4.
    Sethi A, Sethi D, Mrig S, Passey JC, Srivastav N (2006) Coexistent acute pyogenic and tubercular petrous apicitis: a diagnostic dilemma. J Laryngol Otol 120(10):875–878CrossRefGoogle Scholar
  5. 5.
    Sharma SC, Baruah P (2003) Sphenoid sinus tuberculosis in children-a rare entity. Int J Pediatr Otorhinolaryngol 67(4):399–401CrossRefGoogle Scholar
  6. 6.
    Turel MK, Rajshekhar V (2013) Sphenoid sinus tuberculosis: a rare cause of visual dysfunction in an adolescent girl. Neurol India 61(2):179–180CrossRefGoogle Scholar
  7. 7.
    Shenoy SN, Raja A (2004) Tuberculous granuloma of the spheno-clival region. Neurol India 52(1):129–130PubMedGoogle Scholar
  8. 8.
    Nayak B, Patnaik S, Sahoo PK, Biswal D (2015) Craniocervical junction tuberculosis: usual pathology at an unusual site. Surg Neurol Int 6:115CrossRefGoogle Scholar
  9. 9.
    Hollinshead WH (1982) Anatomy for surgeons: vol 1: the head and neck, vol 3(1), 3rd edn. Harper and Row, Philadelphia, p 275Google Scholar
  10. 10.
    Chauhan A, Gupta BB (2007) Spinal tuberculosis. Indian Acad Clin Med 8:110–114Google Scholar
  11. 11.
    Dass B, Puet TA, Watanakunakorn C (2002) Tuberculosis of the spine (Pott’s disease) presenting as ‘compression fractures’. Spinal Cord 40:604–608CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2017

Authors and Affiliations

  • Hitesh Verma
    • 1
    Email author
  • Smriti Panda
    • 1
  • Kapil Sikka
    • 1
  • David Victor Kumar Irugu
    • 1
  • Alok Thakar
    • 1
  1. 1.Department of Otorhinolaryngology, Head & Neck SurgeryAll India Institute of Medical SciencesNew DelhiIndia

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