Dr. Franco Louie L.B. Abes of the UST Faculty of Medicine and Surgery (USTFMS) was speaker at the round table discussion on diagnostic dilemmas in otitis media at the 10th International Conference on Cholesteatoma and Ear Surgery held from June 5 to 8, 2016 in Edinburgh, Scotland, United Kingdom. He also submitted an iposter on tuberculous otitis media with cholesteatoma.
Abes presented his retrospective study on the varied clinical presentation of TB otitis media (TBOM). Despite its rarity in well-developed countries, the disease retains significance due to its appearance in migrant populations and immunocompromised individuals. Also, normal-looking individuals may have the disease: diagnosis is delayed and treatment may fail, resulting in profound hearing loss and other serious complications. The study sought to identify predictors to enhance suspicion of TB otitis media, so early detection can improve treatment outcomes.
Abes’ group urged that Indicators of TBOM, such as past and personal history favoring TB infection and positive chest x-ray and Mantoux test results should not be disregarded. A positive Mantoux test is common and frequently regarded as a sign of past TB exposure in high-burden areas, such as the Philippines but a positive test among individuals who had a previous negative result and are living in low-burden areas may indicate the presence of active infection.
A closer study of the CT scan images of the temporal bone and tissue specimen biopsy must be routinely requested to exclude TBOM, they recommended. Microbiologic diagnosis of the middle ear and the mastoid specimen should be sought and, if possible, also should be combined with the PCR test for M. tuberculosis.
According to Abes, his group’s experiences indicate that regardless of the type of middle ear reconstructive procedure done, there was not much difference in the treatment outcome be it clinically, radiologically, or audiometrically. That is, patients who had more complicated procedures done, such as tympanoplasty with ossiculoplasty, had similar results as compared with those who only had a tympanoplasty done. In fact, there were more notable improvements seen in the case who had no middle ear or mastoid surgery done and in those cases who had a myringotomy performed.
Abes currently teaches otorhinolaryngology, gross anatomy and pediatric audiology at the USTFMS. He is ENT consultant at several medical centers in Metro Manila.
He obtained his medical degree and residency training in Otorhinolaryngology-Head and Neck Surgery at the UP-PGH. He was Honorary Research Fellow at the- Department of Neuro-Otology, The National Hospital for Neurology and Neurosurgery – University College London Hospitals in 2013 and Fellow and Scientific Researcher in Otology – KNO department – Radboud University Medical Center Nijmegen, The Netherlands in 2015.