[Mycobacterial cervical lymphadenitis: role of surgery].
OBJECTIVE
To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis.


METHODS
It's a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted.


RESULTS
The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases.


CONCLUSIONS
Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation.


CONCLUSIONS
Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.
Mani
R
R
CHU Farhat Hached, Service ORL, 4000 Sousse, Tunisie. mani_radhouane@yahoo.fr
Belcadhi
M
M
Harrathi
K
K
Rejeb
A Ben
AB
Benali
M
M
Abdelkefi
M
M
Bouzouita
K
K
Bouzouita
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery*
D000904:Antibiotics, Antitubercular