Role of Surgical Intervention in Treatment of Tubercular Lymphadenitis in Neck Region

Abstract

INTRODUCTION -Lymphadenitis is the most common extrapulmonary manifestation of tuberculosis. It is important for otolaryngologists to be aware of TB in head and neck region and its various manifestations. Lymphadenopathy can progress to abscess and fistula formation, which can be disabling and socially unacceptable. ATT under dots is the main treatment while surgery is required for enlarged lymph nodes or tuberculous lymph node which does not regress with medication. OBJECTIVE -This study aims to find the role of surgical excision of lymph nodes in treatment of tuberculosis of neck lymph node. MATERIALS AND METHODS -Total 91 patients were diagnosed first time with tuberculosis of neck lymph node. All patients were started on anti tubercular treatment. Those patients who had been cured after completion of ATT cat-I, were followed up for 1 year. Surgical intervention (adjuvant to ATT cat-II ) was done in patients who were not cured after ATT cat-1, or had relapse in 1 year follow up. RESULTS -Surgical interventions were done in total 37 patients (25 treatment failure patients and 12 relapse patients). and all patients who got surgical interventions had no relapse or treatment failure during follow up. CONCLUSION-In patients who are not cured with ATT alone, early surgical intervention reduce complications such as abscess, sinus, fistula formation, or spread of disease to other parts of body. Timely surgical intervention also reduce the morbidity and increase the quality of life of patients.

The role of repeated aspirations in the treatment of tubercular cervical lymphadenitis

“…Sui reported 100% cure rate only after excision of all grossly enlarged lymph nodes [6]. Similarly Indulkar P et.al in their study of 91 patients of cervical tuberculosis of lymph nodes have reported a high failure rate with only 66 patients being cured by ATT alone and in the rest 25 patients who developed abscess or enlargement of lymph nodes,lymph node dissection was performed [18].…”

Tuberculous Lymphadenitis in Immunocompromised Patients: A Case Report

“…Among these patients, 12 (13%) recurred after the end of treatment, which suggested surgical treatment to have more promising results. 9,10 Patients with TB and diabetes had 30% greater odds of mortality, required more extended treatment, and were longer to achieve negative M.Tb cultures. Having diabetes as comorbidity negatively affects patient outcomes.…”