Needle aspiration as therapeutic management for suppurative cervical lymphadenitis in children

Abstract

PurposeThis study aimed to evaluate the usefulness of the needle aspiration alternative to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage.MethodsFrom January 1998 to June 2008, we retrospectively reviewed 38 children treated with needle aspiration as management with suppurative cervical lymphadenitis instead of open surgical drainage.ResultsAll 38 children underwent only 1 puncture. Two patients (5.2%) out of 38 patients experienced reformation of an abscess and all recovered completely after re-treatment with antibiotics. Minor complications were detected in 2 patients (5.2%). One complication originated from remnant necrotic tissue and the other involved formation of a small scar in two patients, which resolved spontaneously. There were no major complications.ConclusionNeedle aspiration can be a simple, safe, and effective alternative procedure to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage.

Minimally invasive approach to suppurated cervical lymphadenitis in children: Our experience on 60 patients

“…Needle aspiration was performed in a series of 35 children, only once in 27 (77%) of them, and there were no major complications and no relapse or scar formation . A similar experience was reported in 2010: Beak et al performed 38 needle aspirations with curative intent. All patients (100%) underwent only 1 puncture.…”

“…Two (5.2%) of 38 patients experienced reformation of an abscess and all recovered completely after antibiotic retreatment. There were no major complications and 2 cases with minor complications, and the remnant necrotic tissue and small scar formation spontaneously resolved in both these cases …”

“…There are many advantages reported for this kind of management, such as avoiding: neck incision and consequent scars, risk of complications of surgery in case of deep or parapharyngeal lymph nodes, general anaesthesia in most cases and painful dressing change as well as removal of drains . Moreover, surgery compared with needle aspiration may not shorten hospitalisation as it was reported by other investigators, because the duration of i.v. antibiotic treatment in our institution does not depend on surgical or aspirational strategy.…”

“…Needle aspiration is usually considered only for culture as a diagnostic tool before surgical drainage, whereas aspiration of suppuration was occasionally proposed with therapeutic intent in the last years . Needle aspiration was performed in a series of 35 children, only once in 27 (77%) of them, and there were no major complications and no relapse or scar formation .…”

Pediatric deep neck infections: efficacy of conservative treatment versus immediate surgical intervention

“…[15,16] On the other hand, the morbidity of surgery (such as the need for anesthesia, scar formation and complications) should be taken into account. Advantages of initial medical treatment include avoidance of iatrogenic injury to great vessels or cranial nerves.…”