title: Diagnostic cervical lymphadenectomy in children: a case for multidisciplinary assessment and formal management guidelines.
abstract: A retrospective review was carried out of all children under 16 years of age that underwent cervical lymphadenectomy in our department within a 7-year period. The pathway of their referral from the community to hospital care was noted. The circumstances surrounding the decision for surgery, including clinical features of lymph nodes and investigation results were also recorded. We concluded that cervical lymphadenectomy is an uncommon occurrence in children with an incidence of 2.5/100,000 per year and a yield rate of 15.8% for serious conditions requiring treatment. We demonstrate the importance of joint decision-making between surgeons and paediatricians to reduce the rate of unnecessary biopsies. We also reveal the inconsistency in the pre-operative investigation of these children leading to a low number of positive biopsies and highlighting the need for formal management guidelines.
authors.affiliation: ENT Department, Queen Alexandra Hospital, Portsmouth, UK. isrouji@hotmail.com
authors.forename: Ibrahim Albert
authors.initials: IA
authors.lastname: Srouji
authors.forename: Nnaemeka
authors.initials: N
authors.lastname: Okpala
authors.forename: Erik
authors.initials: E
authors.lastname: Nilssen
authors.forename: Simon
authors.initials: S
authors.lastname: Birch
authors.forename: Phillip
authors.initials: P
authors.lastname: Monnery
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019091:Critical Pathways; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000175:diagnosis*; D008297:Male; D009333:Neck; D010043:Outcome and Process Assessment, Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies