Penfold C N, Revington P J
Oral and Facial Surgery Unit, Glan Clwyd Hospital, Rhyl, UK.
Br J Oral Maxillofac Surg. 1996 Dec;34(6):508-10. doi: 10.1016/s0266-4356(96)90246-6.
to review the clinical features and management of tuberculosis of the head and neck and to identify those features which may aid diagnosis.
retrospective study.
teaching hospital, England, UK.
Twenty-three patients with tuberculosis of the head and neck diagnosed by culture of specimens obtained by fine needle biopsy (n = 8) or by open biopsy of the lumps in the neck (n = 15) who presented between 1990 and 1993.
methods of diagnosis and management.
thirteen of the 23 patients (57%) presented with either a fluctuant mass or a discharging sinus in the neck. Nine (39%) had uncomplicated enlarged lymph nodes and 12 (55%) had systemic symptoms. The supraclavicular region was the most common site (n = 11) and 8 of these 11 had abnormalities in the chest radiograph. In 3 patients the disease was resistant to treatment with standard antituberculous treatment.
atypical mycobacterial lymphadenitis is usually resistant to standard antituberculous treatment, so it is essential to obtain a microbiological diagnosis. Excision is usually the treatment of choice for such patients.
回顾头颈部结核的临床特征及治疗方法，并确定有助于诊断的特征。
回顾性研究。
英国英格兰的教学医院。
1990年至1993年间，23名头颈部结核患者，其中8例通过细针穿刺活检获取标本培养确诊，15例通过颈部肿块开放活检确诊。
诊断和治疗方法。
23例患者中，13例（57%）颈部出现波动感肿块或窦道排脓。9例（39%）有单纯性淋巴结肿大，12例（55%）有全身症状。锁骨上区域是最常见部位（11例），这11例中有8例胸部X线片异常。3例患者对标准抗结核治疗耐药。
非典型分枝杆菌淋巴结炎通常对标准抗结核治疗耐药，因此进行微生物学诊断至关重要。此类患者通常首选手术切除治疗。
