Long-term outcome of surgical excision for treatment of cervicofacial granulomatous lymphadenitis in children.
(2020) European Archives of Oto-Rhino-Laryngology — Vol. 277, n° 6, p. 1785-1792 (2020)
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- (en) 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.
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Neven, Q., Van der Linden, D., Hainaut, M., & Schmitz, S. (2020). Long-term outcome of surgical excision for treatment of cervicofacial granulomatous lymphadenitis in children. European Archives of Oto-Rhino-Laryngology, 277(6), 1785-1792. https://doi.org/10.1007/s00405-020-05880-5 (Original work published 2020)