Primary Spheno-Petro-Clival Tuberculosis

Abstract

The increase awareness and advent of anti-tuberculosis therapy led to decline in tuberculosis. Now a resurgence of tuberculosis is with immunosuppression and with resistant strains. The detection rate of extrapulmonary is increased with the advent of newer modalities of detection, imaging, and better testing. This case series documents our experience with seven cases of primary spheno-petro-clival lesion and details of the clinical and radiological presentations of these patients. Intraoperative obtained tissue was send for histopathological and microbiological evaluation. The most common symptoms were headache and nasal discharge. The final diagnosis of spheno-petro-clival tuberculosis was confirmed in all cases with histopathology and by culture post-operatively. Skull base tuberculosis is relative rare entity in past because of late occurrence of specific symptom, incomplete radiological evaluation and it may present as neck swelling by travelling through various neck spaces. (1) Tubercular infection should be considered as differential in skull base lesion as pickup rate is increasing with advancement in technology. (2) Two of our cases had retropharyngeal abscess have focus in skull base bone. The skull base, hence, may be one of foci in undetermined sites of tuberculous infections and should be searched for.