Ultrasound-Guided Needle Aspiration vs. Surgical Incision of Parotid Abscesses

Abstract

Objective: Standard treatment of parotideal abscesses consists of surgical drainage. This often has to be carried out in general anesthesia and carries the risk of iatrogenic injury of the facial nerve. Ultrasound-guided needle aspiration is an alternative therapy. Up until now a lack of systematic data concerning this subject exists. The study at hand aims to answer the question whether needle aspiration is a viable alternative for surgical drainage. Methods: All patients who had been treated surgically (n = 39) or via ultrasound-guided needle aspiration (n = 18) at our clinic were included into this monocentric retrospective analysis. Results: There was no statistically significant difference (p = 0.142) regarding the mean abscess volume in both groups (5.7 vs. 10.1 mL). Therapy of the abscesses on average required 1.88 (1–5) ultrasound-guided needle aspirations or 1.10 (1–4) surgical interventions. There was a trend to a shorter inpatient treatment period (5.88 vs. 7.33 days) after ultrasound-guided needle aspiration. This trend did not reach statistical significance (p = 0.301). Facial nerve alterations did not occur in any of the patients. Postoperative bleeding did never occur after needle aspirations but in 2% of the patients after surgical abscess revision. Conclusion: Ultrasound-guided needle aspiration is safe and effective in the treatment of parotid abscesses.

Ultrasound-guided puncture drainage versus surgical incision drainage for deep neck space abscesses: a protocol for a systematic review with meta-analysis and trial sequential analysis

“…Minimally invasive techniques, such as ultrasoundguided puncture drainage, have been used to treat abscesses of the head and neck, even some DNAs. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Ultrasound-guided puncture drainage can avoid the above drawbacks of surgical incision drainage and provide several advantages. First, ultrasound-guided puncture drainage can accurately locate the DNAs, eliminating trauma to the neighbouring vital structures and avoiding tumour dissemination during surgical incision.…”

“…Several studies have shown that ultrasound-guided puncture drainage is a more effective option than surgical incision drainage for some DNAs. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] In addition, ultrasound-guided puncture drainage can reduce the length of hospital stay. [25][26][27][28][29] However, most of these studies were case series, reviews and retrospective studies, and prospective and randomised controlled trials are rare.…”

“…[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] In addition, ultrasound-guided puncture drainage can reduce the length of hospital stay. [25][26][27][28][29] However, most of these studies were case series, reviews and retrospective studies, and prospective and randomised controlled trials are rare. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] In this situation, controversies still exist in the selection of drainage technique for the treatment of DNAs.…”

“…[25][26][27][28][29] However, most of these studies were case series, reviews and retrospective studies, and prospective and randomised controlled trials are rare. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] In this situation, controversies still exist in the selection of drainage technique for the treatment of DNAs. 37 38 Therefore, it is necessary to conduct a systematic review and meta-analysis to analyse the clinical efficacy of ultrasound-guided puncture drainage for DNAs.…”