Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands.
Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands; Department of Oral and Maxillofacial Surgery, Amstelland Hospital, Amstelveen, the Netherlands.
J Pediatr Surg. 2023 Sep;58(9):1770-1775. doi: 10.1016/j.jpedsurg.2023.01.044. Epub 2023 Jan 28.
Nontuberculous mycobacterial (NTM) cervicofacial lymphadenitis is a rare infection which almost exclusively occurs in children, most commonly children 0-5 years old. It can leave scars in highly visible areas. The present study aimed to evaluate the long-term esthetic outcome of different treatment modalities for NTM cervicofacial lymphadenitis.
This retrospective cohort study included 92 participants with a history of bacteriologically proven NTM cervicofacial lymphadenitis. All patients were diagnosed at least 10 years prior and were aged >12 years upon enrollment. Based on standardized photographs, the scars were assessed by subjects with the Patient Scar Assessment Scale, and by five independent observers with the revised and weighted Observer Scar Assessment Scale.
The mean age at initial presentation was 3,9 years and the mean follow-up time was 15.24 years. Initial treatments included surgical treatment (n = 53), antibiotic treatment (n = 29) and watchful waiting (n = 10). Subsequent surgery was performed in two patients, due to a recurrence after initial surgical treatment, and in 10 patients initially treated with antibiotic treatment or watchful waiting. Esthetic outcomes were statistically significantly better with initial surgery, compared to initial non-surgical treatment, based on patient scores of scar thickness, and based on observer scores of scar thickness, surface appearance, general appearance and the revised and weighted sum score of all assessment items.
The long-term esthetic outcome of surgical treatment was superior to non-surgical treatment. These findings could facilitate the process of shared decision making.
Level III.
非结核分枝杆菌（NTM）颈面部淋巴结炎是一种罕见的感染，几乎仅发生于儿童，最常见于 0-5 岁儿童。它会在高度可见的区域留下疤痕。本研究旨在评估不同治疗方法对 NTM 颈面部淋巴结炎的长期美观效果。
这是一项回顾性队列研究，纳入了 92 例经细菌学证实的 NTM 颈面部淋巴结炎患者。所有患者的诊断均在 10 年以上，且在入组时年龄>12 岁。根据标准化照片，由患者用患者疤痕评估量表（Patient Scar Assessment Scale）和 5 位独立观察者用改良和加权观察者疤痕评估量表（revised and weighted Observer Scar Assessment Scale）对疤痕进行评估。
初次就诊时的平均年龄为 3.9 岁，平均随访时间为 15.24 年。初始治疗包括手术治疗（n=53）、抗生素治疗（n=29）和观察等待（n=10）。在最初接受手术治疗的 2 例患者中，由于初次手术后复发，在最初接受抗生素治疗或观察等待的 10 例患者中，因复发而再次进行了手术。根据患者对疤痕厚度的评分，以及根据观察者对疤痕厚度、表面外观、整体外观和所有评估项目的改良和加权总和评分，初始手术的美观效果明显优于初始非手术治疗。
手术治疗的长期美观效果优于非手术治疗。这些发现可以促进共同决策的过程。
III 级。
