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Parotid fistula in children in the tropics
1E.N.T. Unit, Lagos University Teaching Hospital, Nigeria.
Insights
Tuberculosis is a common cause of parotid fistulae in Nigerian children, often originating in the palatine tonsils. Tonsillectomy is crucial for effective treatment when other methods fail.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Diseases
Background:
- Parotid fistulae in children can arise from various causes, including infection, trauma, and malignancy.
- Tuberculosis has been identified as a significant infectious etiology, often with the palatine tonsil as the primary site.
Purpose of the Study:
- To investigate the causes of parotid fistulae in Nigerian children.
- To determine the efficacy of different treatment modalities, particularly in cases related to tuberculosis.
Main Methods:
- A retrospective study of 15 Nigerian children diagnosed with parotid fistulae.
- Analysis of etiological factors, including infection, trauma, and carcinoma.
- Evaluation of treatment outcomes for various interventions, including tympanic neurectomy, surgical repair, and anti-tuberculous therapy.
Main Results:
- Infection was the leading cause (60%), followed by trauma (33.3%) and carcinoma (6.7%).
- Tuberculosis was the most frequent infection, characterized by palatine tonsil involvement and tonsillar gland enlargement.
- Cases involving tuberculosis showed poor response to standard treatments until palatine tonsillectomy was performed.
Conclusions:
- Palatine tonsil tuberculosis is a critical, often overlooked, cause of parotid fistulae in children.
- Palatine tonsillectomy should be considered in the management of pediatric parotid fistulae when tuberculosis is suspected.
- Investigating the tonsils as a primary site for tuberculous infection is essential for successful head and neck lesion treatment.
Abstract:
A study of 15 Nigerian children with parotid fistulae was carried out. The causes of the fistulae were found to be infection in nine children (60%), trauma in five (33.3%) and carcinoma in one (6.7%). The commonest infection was tuberculosis, with the primary site in the palatine tonsil and with associated tonsillar gland enlargement. In these cases there was no good response to tympanic neurectomy, surgical repair and anti-tuberculous therapy until palatine tonsillectomy was performed. It is therefore advised that the continued role of the tonsils as a primary site of tuberculous infection in the head and neck must always be sought, even in the management of parotid fistulae in children.