Issue N# 2 - 2005
HEAD AND NECK
Mycobacterial cervical lymphadenitis: Role of surgery
Authors : R. Mani, M. Belcadhi, K. Harrathi, A. Ben Rejeb, M. Benali, M. Abdelkefi, K. Bouzouita, H. Bouzouita (Sousse)
Ref. : Rev Laryngol Otol Rhinol. 2005;126,2:99-103.
Article published in french
Downloadable PDF document french
Objective: To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis. Patients and methods: Itís a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted. Results: The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases. Discussion: Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation. Conclusion: Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.
Price : 10.50 €