Non-tuberculous mycobacterial head and neck infections in children: Analysis of results and complications for various treatment modalities

Mahadevan, Murali; Neeff, Michel; Meer, Graeme van der; Baguley, Campbell; Wong, Wai Keat; Gruber, Maayan

doi:10.1016/j.ijporl.2015.12.026

Cited by 21 publications

(12 citation statements)

References 18 publications

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“…On the basis of the exclusion criteria, 8 of the 21 initially selected papers were included in this review, corresponding to 571 patients. 2,[6][7][8][9][10][11][12][13] Table 1 shows their main characteristics and surgical results.…”

Section: Resultsmentioning

confidence: 99%

“…The management of children with cervico-facial NTML is challenging: medical protocols consist of long-term anti-mycobacterial treatment with a clarithromycin-based multi-drug regimen, but the infection may progress and untoward events may be responsible for treatment discontinuation. 12 A watchful waiting strategy has been advocated by some authors on the grounds that NTML is essentially a self-limiting disease and complications unrelated to cosmetic appearance are extremely rare in immunocompetent children. 9 Surgical strategies include complete excision, incision and drainage, incision and curettage, incisional biopsy, and aspiration.…”

Section: Discussion and Practical Recommendationsmentioning

confidence: 99%

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Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review

Torretta

Gaffuri

Ibba

et al. 2018

Int J Immunopathol Pharmacol

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Non-tuberculous mycobacterial lymphadenitis (NTML) accounts for about 95% of the cases of head-and-neck mycobacterial lymphadenitis, and its prevalence has been increasing in the Western world. The diagnostic work-up can be challenging, and differential diagnoses such as tuberculous and suppurative lymphadenitis need to be considered. It may, therefore, not be diagnosed until the disease is in a late stage, by which time it becomes locally destructive and is characterized by a chronically discharging sinus. The treatment options include a medical approach, a wait-and-see policy, and surgery, with the last being considered the treatment of choice despite the high risk of iatrogenic nerve lesions. The aim of this article is to provide an overview of pediatric, head-and-neck NTML based on the literature and our own experience, with particular emphasis on the impact and limitations of surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Discussion and Practical Recommendationsmentioning

confidence: 99%

Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review

Torretta

Gaffuri

Ibba

et al. 2018

Int J Immunopathol Pharmacol

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“…Parker found no significant impact factors for postoperative complications, such as facial nerve dysfunction, recurrence, wound infection and poor scarring [17]. Peripheral facial nerve paresis or paralysis represents a major risk of surgery, especially for lesions located on the submandibular pedicle or on the parotid space [18]. Spinal accessory nerve damage after resection of high jugular nodes has also been reported [19], but it is uncommon.…”

Section: Discussionmentioning

confidence: 99%

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

Neven¹,

Linden

Hainaut

et al. 2020

Eur Arch Otorhinolaryngol

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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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“…Zusätzlich können durch die Untersuchung der gewonnenen Gewebeprobe weitere Erkrankungen mit einem ungünstigeren Verlauf ausgeschlossen werden. Die komplette Entfernung stellt die effektivste Methode dar [13][14][15][16]. Das Anstreben einer kompletten Resektion kann mit einem erhöhten Komplikationsrisiko behaftet sein.…”

Section: Materials Und Methodenunclassified

Zervikale Lymphadenitis durch atypische Mykobakterien bei Kindern mit unterschiedlichem Wohnsitz

Papatsoutsos

Aumann

Vorwerk

et al. 2020

Laryngorhinootologie

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Zusammenfassung Hintergrund Die atypischen Mykobakterien stellen eine inhomogene Gruppe dar. Obwohl mehr als 140 Spezies identifiziert wurden, stehen nur 25 mit der atypischen Mykobakteriose beim Menschen in Beziehung. Die häufigste Manifestation bei immunkompetenten Kindern ist die zervikale Lymphadenitis. Das Ziel der vorliegenden Arbeit ist die Korrelation des Lebensraums mit den Patientendaten und dem Krankheitsbild, die Auswertung der sonografischen Befunde und der operativen Therapiemethoden und die Erstellung eines Diagnose- und Therapiealgorithmus. Material und Methoden Die Patienten wurden nach einer systematischen Suche in der klinischen, mikrobiologischen und pathologischen Datenbank der HNO-Klinik identifiziert. Eine statistische Analyse der Ergebnisse wurde durchgeführt. Ergebnisse 32 Patienten wurden ausgewertet. Eine signifikante Korrelation zwischen dem Wohnort und der Manifestation oder dem Verlauf der Erkrankung konnte nicht nachgewiesen werden. Echoarme Lymphknoten mit intraglandulärer Nekrose und niedriger Durchblutung wurden bei der Mehrheit der Patienten beobachtet. Die verwendeten operativen Methoden schlossen die Abszessinzision mit Biopsie, die diagnostische Lymphadenektomie, die selektive Neck-Dissection und die laterale Parotidektomie ein. Die Rezidivrate war signifikant höher nach Abszessinzision als nach Lymphadenektomie oder selektiver Neck-Dissection. Schlussfolgerungen Um den Einfluss des Wohnsitzes auf das Krankheitsbild deutlich zu definieren, sind größere prospektive Studien notwendig. Die sonografischen Befunde sind diagnostisch wegweisend. Eine vollständige Resektion trägt zur Diagnose und Therapie bei und stellt eine risikoarme Therapieoption dar.

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Non-tuberculous mycobacterial head and neck infections in children: Analysis of results and complications for various treatment modalities

Cited by 21 publications

References 18 publications

Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review

Surgical treatment of non-tuberculous mycobacterial lymphadenitis in children: Our experience and a narrative review

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

Zervikale Lymphadenitis durch atypische Mykobakterien bei Kindern mit unterschiedlichem Wohnsitz

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