tuberculous otitis media leading to sequentialib bilateral facial nerve paralysis

introduction: tuberculous otitis media (tom) is an uncommon, insidious, and frequently misdiagnosed form of tuberculosis (tb). in particular, tom is usually secondary to direct transmission from adjacent organs, while the primary form has been rarely reported. the main aim of treatment is to start the patient on an antitubercular regime and early surgical intervention to decompress the facial nerve if involved.   case report: the case report of a twenty year-old male with bilateral tuberculous otitis media, who presented himself with fever followed by sequential bilateral facial nerve paralysis, bilateral profound hearing loss, and abdominal tuberculosis leading to intestinal perforation, is presented. to the best available knowledge and after researching literature, no such case depicting the extensive otological complications of tuberculosis has been reported till date.    conclusion:  tuberculosis of the ear is a rare entity and in most cases the clinical features resemble that of chronic otitis media. the diagnosis is often delayed due to varied clinical presentations and this can lead to irreversible complications. early diagnosis is essential for prompt administration of antitubercular therapy and to prevent complications.