SINCE the introduction of effective antibiotics, tuberculosis of the middle ear has become a rare entity in the United States and other western countries. Only 11 of 23,000 cases of suppurative otitis media reported from Great Britain during 1950 to 1959 were attributable to Mycobacterium tuberculosis . 1 This represented a substantial change from an early report 2 in which chronic suppurative otitis media was described as being of tuberculous origin in 50% of infants younger than 1 year, 27% of infants younger than 2 years, and 2% of children younger than 15 years. Primarily a disease of children, it has occasionally been reported in adults. 1,3,4 Although it is rare, tuberculous otitis media remains a serious disease. The often painless nature of the infection and low diagnostic suspicion by clinicians serve to delay diagnosis. This may result in severe complications, including deafness, ataxia, cranial nerve palsy, and intracranial abscesses or