Oblique facial clefts (Tessier Clefts) are severe orofacial clefts beyond the lip and palate that count among the rare congenital malformations "with an incidence of 1.43 to 4.85 per 100,000 births."1,2 The Tessier Classification System devised by Paul Tessier in 1976 assigned specific caudo-cranial numbers to clefts involving the "soft tissue and underlying bones of the mouth, maxilla, nose, eyes, and forehead" in relation to the sagittal midline of the face.1,3,4 The midline is designated 0 - 14, and adjacent clefts are numbered 1-13, 2-12 and so on, depending on the location and axis of the malformation. We present a patient with a bilateral Tessier 5 cleft.

Human ; Male ; Child Preschool (a Child Between The Ages Of 2 And 5) ; Face

OBJECTIVE: The aim of this report is to describe an aggressive case of tuberculous otitis media in a young child and emphasize that surgical intervention and histopathologic studies can be employed to immediately arrive at a definitive diagnosis.

METHODS:

          Design:           Case Report

          Setting:           Tertiary Government Training Hospital

          Participants:  One

RESULTS: This is a case of a four-year-old boy who had refractory otitis media and erosive CT scan findings, mimicking aggressive CSOM manifestations. Due to unusual intraoperative granulation tissue characteristics, it was initially considered a malignancy, necessitating surgical intervention and biopsy that resulted in a definitive diagnosis of primary middle ear tuberculosis.

CONCLUSION: This case represents the more severe end of the spectrum of tuberculous otitis media and supports the recommendation that a high index of suspicion, early detection, and prompt initiation of treatment are imperative in its management, especially in children with refractory otitis media.

 

Human ; Tuberculosis ; Ear, Middle ; Otitis Media