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Minimally invasive and inexpensive percutaneous abscess drainage using an indwelling needle cannula
Kumiko Tanaka1, Atsunobu Tsunoda1, Miri Tou1
1Department of Otolaryngology, Juntendo University, Nerima Hospital, Japan.
Insights
This study introduces a minimally invasive technique for abscess drainage using an indwelling needle cannula, offering effective treatment with no visible scars, especially beneficial for pediatric head and neck abscesses.
Area of Science:
- Minimally Invasive Surgery
- Pediatric Otolaryngology
- Interventional Radiology
Background:
- Abscesses in the head and neck present significant challenges, particularly regarding cosmetic outcomes in pediatric patients.
- Adequate drainage is crucial for effective abscess management.
- Existing drainage methods may lead to scarring, necessitating refined techniques.
Purpose of the Study:
- To introduce and evaluate a novel percutaneous abscess drainage method using an indwelling needle cannula.
- To assess the safety, efficacy, and cosmetic results of this technique in pediatric and adult patients.
- To provide a simple, inexpensive, and minimally invasive alternative for abscess treatment.
Main Methods:
- A retrospective review of 15 patients (10 pediatric, 5 adult) with cervical and/or facial abscesses treated with the technique.
- Percutaneous abscess penetration under ultrasonic guidance using an 18-14 G indwelling needle cannula.
- Continuous suction drainage via the indwelling cannula for larger abscesses.
Main Results:
- Successful treatment of various abscess types, including dental, lymphadenitis, and post-mastoiditis origins.
- Median drainage duration of 4 days (range 3-9 days).
- No patients required additional surgical incision, and no apparent scars were observed post-drainage.
Conclusions:
- Percutaneous abscess drainage with an indwelling needle cannula is a safe, effective, and minimally invasive procedure.
- The technique is familiar to physicians due to its similarity to venous cannulation.
- This method offers excellent cosmetic results, particularly for pediatric head and neck abscesses.
Purpose:
Abscess is still a formidable disease and requires adequate drainage. Moreover, drainage in the head and neck area needs cosmetic care, especially in the pediatric population. In this report, we introduce our method of percutaneous abscess drainage using an indwelling needle cannula.
Patients And Methods:
Ten pediatric and five adult patients with cervical and/or facial abscess treated with this drainage method were retrospectively reviewed. Using an indwelling needle cannula (18-14 G Surflow®, Terumo, Tokyo, Japan), abscesses were penetrated under ultrasonic examination. Once purulent retention was identified, the inner metal needle was removed and the outer elastic needle was left and fixed. The outer needle was connected to the tube for continuous suction drainage for large abscess.
Results:
The primary diseases of these abscesses were cervical abscess of dental origin (5), purulent lymphadenitis (3), pyriform sinus fistula (2) and subperiosteal abscess due to mastoiditis (2), circumorbital cellulitis (1), infection of Warthin's tumor (1), and unknown origin (1). The median (range) duration of drainage was 4 days (3-9 days). Abscesses were successfully treated, and no patients required additional incision for abscess drainage. No apparent scars after drainage were observed.
Conclusion:
This technique resembles the usual venous placement of an indwelling needle cannula and is thought to be familiar to physicians. Although simple and inexpensive, this drainage is safe, effective, and minimally invasive for the treatment of abscess.
