Work

Characteristics and prognosis of intractable otomastoiditis caused by nontuberculous mycobacteria

Year: 2025

Type: article

Abstract: To clarify the clinical characteristics, management, and prognosis of nontuberculous mycobacteria (NTM) otomastoiditis, a rare and intractable disease with high relapse risk. This study presents the largest case series to date, analyzing 30 patients with NTM otomastoiditis. This retrospective case series was conducted at a single tertiary referral center. Clinical data including causative pathogens, imaging findings, antibiotic regimens, surgical interventions, complications, and audiometric outcomes were reviewed and analyzed. Among the 30 patients (14 males; mean age 55 ± 20 years), Mycobacterium abscessus was identified in 26 (87 %) cases. Skull base osteomyelitis or intracranial involvement was present in 7 (23 %) patients. All patients received anti-NTM antibiotics, with macrolides being the most frequently prescribed. The median antibiotic duration was 13 months. Twenty-three (77 %) patients underwent surgery, and 12 (40 %) had additional operations. Among 23 patients with complete audiometric data, mean air-conduction hearing thresholds improved from 64.1 to 55.6 dB HL ( p = 0.04); however, irreversible total deafness developed in 3 patients. Nontuberculous mycobacterial otomastoiditis requires early recognition and comprehensive management. Combined surgical debridement and prolonged antibiotic therapy are often necessary, and all patients can achieve disease control. Hearing outcomes vary, but functional preservation is possible in appropriately managed cases. • This study presents the largest single-center case series of 30 patients with nontuberculous mycobacterial (NTM) otomastoiditis. • Mycobacterium abscessus was the most common pathogen, identified in 87 % of cases. • Combined prolonged antibiotic therapy and surgical debridement led to disease resolution in all patients. • Modest hearing improvement was observed in many patients after treatment, although three patients developed irreversible total deafness. • 18F-FDG-PET may serve as a useful adjunct to conventional imaging in evaluating treatment response when endpoints are unclear.

Source: American Journal of Otolaryngology

DOI: 10.1016/j.amjoto.2025.104728

Authors: Bang-Yan Zhang, Chen-Chi Wu, Tien-Chen Liu, Ting-Hua Yang

Institutions: Fu Jen Catholic University, National Taiwan University Hospital, National Taiwan University

Language: English

Topic: Mycobacterium research and diagnosis

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,630