Parotid tuberculosis remains a very rare localization in the Department of Otolaryngology and Cervico-Facial Surgery (ENT) sphere. It is presented in the form of a deceptive clinical picture causing confusion with other pathologies of the parotid gland, including tumor pathology. In addition, its lack of knowledge by practitioners increases the risk of missing the diagnosis. Often, the diagnosis is a histological surprise on a piece of excision after an exploratory parotidectomy. However, its treatment is primarily medical if the positive diagnosis is well established. We report medical observation of two new cases aged 44 and 45 respectively, who consult our center for parotid swelling. Radiological examinations were in favor of intraparotid cystic lesions. Both patients benefited from an excision whose histopathological study was in favor of primary parotid tuberculosis. The subsequent evolution was favorable under antituberculous treatment.
The challenge in management of chronic retro-pharyngeal abscess lies in its proximity to vascular and neurological structures, the access to the abscess should be possible after evaluation of neurological stability and integrity of vascular structures. Tuberculous chronic retro-pharyngeal abscess is an unusual situation. And due to its scarcity, it is not considered in differential diagnosis which delays its management: this could lead to permanent neurological deficit and higher rates of mortality. This the case of a young 29-year-old male, already undergoing anti-tuberculosis treatment for 2 months for a tuberculous lymphatitis, and no history of immuno-suppression, presenting with a large retropharyngeal abscess, with no neurological symptoms or any other specific symptoms. The management of this disease can be simple provided the diagnosis is not delayed, the patient had no complications, and the follow up is performed by a team: otolaryngologist, a neurosurgeon and a phthisiology specialist.<p>聽</p>
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