目的早期诊断,早期治疗,防止严重的听力损失及并发症的发生,以免漏诊,明确诊断及治疗。方法选取9例结核性中耳炎患者,采取临床检查明确诊断后手术治疗和抗结核、支持治疗。合并有中耳胆脂瘤,或引流不畅、抗结核治疗无效者,全麻插管麻醉下行“右耳鼓室鼓窦探查术+乳突根治术”。结果出院后续服抗结核药0.5~1年左右,门诊换药,随访结果显示患者病情痊愈,干耳,术腔均上皮化,无复发,面瘫完全恢复。结论结核性中耳炎临床表现不典型,易误诊或漏诊,应引起临床医生重视,并给予及时诊断及治疗。结核性中耳炎合并面瘫等严重并发症时,应行手术清除中耳内炎性肉芽组织及死骨,通畅引流,防止并发症,并于术后行常规抗感染治疗合并抗结核治疗。 Objective Early diagnosis, early treatment, to prevent severe hearing loss and complications, so as to avoid misdiagnosis, a clear diagnosis and treatment. Methods Nine patients with tuberculous otitis media were selected. Clinical examination was made to confirm the postoperative diagnosis and treatment of tuberculosis and supportive treatment. Combined with middle ear cholesteatoma, or poor drainage, anti-TB treatment ineffective, general anesthesia intubation anesthesia “right ear drum sinus exploration + mastoidectomy ”. Results After discharge, the anti-TB drugs were continued for about 0.5 to 1 year after discharge. The outpatient dressing was changed. The follow-up results showed that the patients recovered, dry ears and epithelialization of the surgical cavity without relapse and facial paralysis completely recovered. Conclusions The clinical manifestations of tuberculous otitis media is not typical, easily misdiagnosed or missed diagnosis should be caused by clinicians, and give timely diagnosis and treatment. Tuberculous otitis media complicated by facial paralysis and other serious complications should be removed surgically in the middle ear inflammatory granulation tissue and sequestrum, smooth drainage, to prevent complications, and after conventional anti-infective therapy combined with anti-TB treatment.