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Long-term outcome of surgical excision for treatment of cervicofacial granulomatous lymphadenitis in children

Authors
  • Neven, Quentin1
  • Van der Linden, Dimitri1, 2
  • Hainaut, Marc3
  • Schmitz, Sandra2, 4
  • 1 St Luc University Hospital, Brussels, Belgium , Brussels (Belgium)
  • 2 Catholic University of Louvain, Brussels, Belgium , Brussels (Belgium)
  • 3 CHU Saint-Pierre, Brussels, Belgium , Brussels (Belgium)
  • 4 Institut Roi Albert II-St Luc University Hospital, Avenue Hippocrate 10, Brussels, 1200, Belgium , Brussels (Belgium)
Type
Published Article
Journal
European Archives of Oto-Rhino-Laryngology
Publisher
Springer Berlin Heidelberg
Publication Date
Mar 06, 2020
Volume
277
Issue
6
Pages
1785–1792
Identifiers
DOI: 10.1007/s00405-020-05880-5
Source
Springer Nature
Keywords
License
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Abstract

PurposeGranulomatous 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.MethodsCase 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.ResultsForty 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.ConclusionWe 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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