Histologically detected extrapulmonary tuberculosis in the head and neck region. A review of 222 cases.

During the 11-year period from 1974 to 1984, 222 cases of non-meningitic extrapulmonary tuberculosis in the head and neck region were seen at the ear, nose and throat departments of the academic hospitals of the University of Pretoria. A retrospective analysis revealed that three structures were mainly involved--the cervical lymph nodes, larynx and middle ear. The diagnoses were all confirmed on histological examination, revealing a positive biopsy rate for tuberculosis of 5% (222) of the total number of specimens submitted for the same period (4,357). Females had more cervical node involvement than males. Ninety per cent of all patients were black and the largest group was under 10 years old. A high index of suspicion of tuberculosis is important in the differential diagnosis of neck swellings, hoarseness and otorrhoea.