Tuberculous otomastoidtis (TOM) is a clinical challenge, which may results in delay or misdiagnosis, subsequently leads to complications. We report a case of TOM of a 50 year old lady with underlying 3 years history of left chronic otitis media who presented with acute facial paralysis. She failed to respond to medical therapy, and thus surgical intervention played a role. It is essential to have high degree of suspicion in establishing the diagnosis of TOM, so that early treatment can be initiated and also prevent complications.
Key words: Tuberculous mastoiditis, otitis media, facial nerve paralysis