Related Experiment Video
Updated: May 31, 2026
A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
Surgical treatment for nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis in children
1Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands. j.a.lindeboom@amc.uva.nl
Insights
Surgical excision offers faster healing for nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis in children compared to curettage. While excision is quicker, curettage may be safer if facial nerve branches are adhered to.
Area of Science:
- Pediatric infectious diseases
- Surgical treatments for lymphadenitis
- Mycobacterial infections
Background:
- Nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis is a common infection in children.
- Treatment options include surgical intervention, with varying outcomes.
- Comparing surgical excision and curettage is crucial for optimizing patient care.
Purpose of the Study:
- To compare the efficacy of surgical excision versus surgical curettage in treating pediatric cervicofacial NTM lymphadenitis.
- To evaluate wound healing times and postoperative complications associated with each surgical method.
Main Methods:
- A randomized study involving 50 children diagnosed with cervicofacial NTM infection.
- Participants were assigned to either surgical excision (25 children) or surgical curettage (25 children).
- PCR or culture confirmation of NTM infection was required for inclusion.
Main Results:
- Surgical excision demonstrated significantly faster wound healing (3.6 weeks) compared to curettage (11.4 weeks).
- Transient marginal mandibular nerve weakness occurred in 16% of the excision group, with full recovery within 12 weeks.
- No facial nerve issues or postoperative infections were reported in the curettage group.
Conclusions:
- Surgical excision provides a more rapid resolution of NTM cervicofacial lymphadenitis in children.
- Surgical curettage, though associated with delayed healing, presents a viable alternative when nerve adherence complicates excision.
- Careful consideration of potential nerve involvement is essential when selecting the surgical approach.
Purpose:
To compare surgical excision with surgical curettage in the treatment of nontuberculous mycobacterial (NMT) cervicofacial lymphadenitis in children.
Patients And Methods:
Fifty children, 22 boys and 28 girls, with a PCR- or cultured-confirmed diagnosis of cervicofacial NTM infection were included in the study. Twenty-five children were randomized to surgical excision of the involved lymph nodes, and 25 children to surgical curettage.
Results:
The median age of the children was 36 months (range, 14-120 months). All children had a red, fluctuating lymphadenitis, and there were no marked differences between the treatment groups with respect to mean duration of lymph node swelling before presentation, location, and the size of the lymph node swelling. Most (84%) of the involved nodes were located in the submandibular region and 6% were located in the preauricular region. Multiple locations (both preauricular and submandibular) were observed in the remaining 10%. Mycobacterium avium (74%) and Mycobacterium haemophilum (22%) were the predominant NTM species. Mean wound healing time for the excision group was 3.6 ± 1.2 weeks versus 11.4 ± 5.1 weeks for the curettage group (P ≤ .05). Postoperative transient marginal mandibular nerve weakness of the facial nerve was seen in 4 patients (16%) of the excision group. In all these patients the function of the nerve returned to normal within 12 weeks. No facial nerve problems were observed in the curettage group. Postoperative infections were not observed.
Conclusions:
Surgical excision leads to a quick resolution of NTM cervicofacial lymphadenitis. Curettage leads to delayed healing but might be considered as an alternative if excision of the necrotized lymph nodes is technically difficult in cases of adherence of the facial nerve branche.
Related Concept Videos
01:26Tonsillitis II: Management
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...