Long-term outcome of surgical excision for treatment of cervicofacial granulomatous lymphadenitis in children
- 6 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Archives of Oto-Rhino-Laryngology
- Vol. 277 (6), 1785-1792
- https://doi.org/10.1007/s00405-020-05880-5
Abstract
Purpose Granulomatous inflammation is a common cause of subacute cervicofacial lymphadenitis in children. Nontuberculous mycobacterial (NTM) infections and cat-scratch disease (CSD) are the most frequent causes. Optimal treatment, which may include surgery, antibiotic treatment or wait-and-see approach, is debatable. The goal of this study was to compare the short- and long-term outcome of various surgical procedures. Methods Case series with a chart review of all children treated by surgical excision of granulomatous lymph nodes in the cervicofacial area from 2000 to 2016 at two tertiary care centers. Results Forty patients were included in this study. The median age at first symptoms was 3.7 years (13 months–14 years). Mean follow-up was 5.8 years (6 months–15.3 years). 25 patients fit with diagnosis of NTM infection, 6 with CSD while diagnosis remained uncertain in 9 patients. The primary surgical procedure consisted of total excision (n = 27), incision/drainage (n = 9) or incomplete excision (n = 4). None of the patients treated by primary complete excision needed further intervention contrary to the group of patients with incomplete surgical procedures where additional surgical management was required in 54%. At follow-up, all patients were healthy without evidence of recurrence. Conclusion We advocate early surgical intervention with complete excision to reach quick resolution and reduce the need for additional surgery. The long-term outcome was favorable.Keywords
This publication has 29 references indexed in Scilit:
- Nontuberculous Mycobacterial Infection in ChildrenThe Pediatric Infectious Disease Journal, 2009
- Interferon- Release Assays Improve the Diagnosis of Tuberculosis and Nontuberculous Mycobacterial Disease in Children in a Country with a Low Incidence of TuberculosisClinical Infectious Diseases, 2007
- Tuberculin Skin Testing Is Useful in the Screening for Nontuberculous Mycobacterial Cervicofacial Lymphadenitis in ChildrenClinical Infectious Diseases, 2006
- Lymph Node Biopsy Specimens and Diagnosis of Cat-scratch DiseaseEmerging Infectious Diseases, 2006
- Nontuberculous mycobacterial adenitis: Effectiveness of chemotherapy following incomplete excisionActa Paediatrica, 2006
- Cat-scratch disease: Otolaryngologic manifestations and managementOtolaryngology -- Head and Neck Surgery, 2005
- Nontuberculous Mycobacterial Adenitis of the Head and Neck in Children: Experience From a Tertiary Care Pediatric CenterThe Laryngoscope, 2001
- Cervical lymphadenopathy secondary to atypical mycobacteria in childrenThe Journal of Laryngology & Otology, 1996
- Cat-scratch disease in Hawaii: Etiology and seroepidemiologyThe Journal of Pediatrics, 1995
- Cervicofacial Mycobacterial Adenitis in ChildrenThe Laryngoscope, 1990