Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-24T17:00:47.426Z Has data issue: false hasContentIssue false
  • English
  • Français

Diagnosis of tuberculosis in the head and neck

Published online by Cambridge University Press:  27 January 2011

K A McAllister  and
F B MacGregor
K A McAllister*
Affiliation:
Department of Otolaryngology, Gartnavel General Hospital, Glasgow, Scotland, UK
F B MacGregor
Affiliation:
Department of Otolaryngology, Gartnavel General Hospital, Glasgow, Scotland, UK
*
Address for correspondence: Miss Kerrie A McAllister, Department of Otolaryngology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, Scotland, UK Fax: (0)141 211 1671 E-mail: kerrie.mcallister@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To establish the features of Mycobacterium tuberculosis infection in the head and neck region, and to determine which investigations have the greatest diagnostic accuracy.

Study design:

Region-based, retrospective cohort study.

Method:

The study included 148 patients with tuberculosis of the head and neck treated in the Greater Glasgow and Clyde region between 2000 and 2007.

Results:

The following diagnostic sensitivities were calculated: 53 per cent for fine needle aspiration, 95 per cent for core biopsy and 91 per cent for lymph node excision biopsy. There was a statistically significant difference between the sensitivity results for fine needle aspiration versus core biopsy (p = 0.0003) and fine needle aspiration versus excision biopsy (p < 0.0001). There was no statistically significant difference between the sensitivity results for core biopsy and excision biopsy.

Conclusion:

Core biopsy has equivalent diagnostic accuracy to excision biopsy in the investigation of head and neck tuberculosis. We suggest that core biopsy should be used in preference to lymph node excision, as it can be performed under local anaesthetic outside the operating theatre. A proposed algorithm for diagnostic management is included.

Keywords

TuberculosisLymph NodeBiopsyOtolaryngology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 6 , June 2011 , pp. 603 - 607
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Scottish Otolaryngological Society Meeting, 7 May 2009, Pitlochry, Scotland, UK

References

1Newlands, SD. Degenerative, idiopathic, and connective tissue diseases. In: Bailey, BJ, Johnson, JT, Newlands, SD, eds. Head & Neck Surgery – Otolaryngology, 4th edn.London: Lippincott Williams & Wilkins, 2006;184–5Google Scholar
2Kruijshaar, M, French, C, Anderson, C, Abubakar, I. Tuberculosis in the UK: Annual report on tuberculosis surveillance and Control in the UK 2007. London: Health Proection Agency for Infections, November 2007Google Scholar
3Nalini, B, Vinayak, S. Tuberculosis in ear, nose, and throat practice: its presentation and diagnosis. Am J Otolaryngol 2006;27:39–45CrossRefGoogle ScholarPubMed
4Ammari, FF, Bani Hani, AH, Ghariebeh, KI. Tuberculosis of the lymph glands of the neck: a limited role for surgery. Otolaryngol Head Neck Surg 2003;128:576–80Google Scholar
5Baek, CH, Kim, SI, Ko, YH, Chu, KC. Polymerase chain reaction detection of Mycobacterium tuberculosis from fine-needle aspirate for the diagnosis of cervical tuberculous lymphadenitis. Laryngoscope 2000;110:30–4CrossRefGoogle ScholarPubMed
6Kim, BM, Kim, EK, Kim, MJ, Yang, WI, Park, CS, Park, SI et al. Sonographically guided core needle biopsy of cervical lymphadenopathy in patients without known malignancy. J Ultrasound Med 2007;26:585–91Google Scholar
7Song, JY, Cheong, HJ, Kee, SY, Lee, J, Sohn, JW, Kim, MJ et al. Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy. J Infect 2007;55:310–16Google Scholar
8Memish, ZA, Mah, MW, Mahmood, SA, Bannatyne, RM, Khan, MY. Clinico-diagnostic experience with tuberculous lymphadenitis in Saudi Arabia. Clinical Microbiology & Infection 2000;6:137–41CrossRefGoogle ScholarPubMed
9Lau, SK, Wei, WI, Hsu, C, Engzell, UC. Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy. J Laryngol Otol 1990;104:24–7CrossRefGoogle ScholarPubMed
10Lau, SK, Wei, WI, Kwan, S, Yew, WW. Combined use of fine-needle aspiration cytologic examination and tuberculin skin test in the diagnosis of cervical tuberculous lymphadenitis. A prospective study. Arch Otolaryngol Head Neck Surg 1991;117:87–90Google Scholar
11Al-Serhani, AM. Mycobacterial infection of the head and neck: presentation and diagnosis. Laryngoscope 2001;111:2012–16CrossRefGoogle ScholarPubMed
12Manolidis, S, Frenkiel, S, Yoskovitch, A, Black, M. Mycobacterial infections of the head and neck. Otolaryngol Head Neck Surg 1993;109:427–33Google Scholar