ABSTRACT
Objective:To investigate the clinical effect of lateral cervical approach in the treatment of cervical lymphatic tuberculosis complicated with parapharyngeal space abscess. Methods:A total of 10 patients with cervical lymph node tuberculosis complicated with tuberculous abscess in parapharyngeal space were treated. Surgery was performed using a transcervical approach. The operation time and blood loss were recorded. The level of ESR, C-reactive proteinï¼CRPï¼, VAS score and the rating of Kubota drinking test before and 2 weeks after operation were compared. The incision healing, symptoms of tuberculosis poisoning, and the CT findings of the cervical lesions were compared before operation, 2 weeks after operation and at the last follow-up. Results:The operation time ranged from 65 to 130 min with an average of ï¼99.00±21.45ï¼ min. The intraoperative blood loss ranged from 100 to 250 mL with an average of ï¼155.00±43.78ï¼ mL. The average pre-and post-operative level of ESR was ï¼67.60±21.94ï¼ mm/1h and ï¼30.30±13.76ï¼ mm/1h, respectivelyï¼U=5.500, P<0.01ï¼; The average pre-and post-operative level of CRP was ï¼69.70±31.13ï¼ mg/L and ï¼42.40±19.70ï¼ mg/L, respectivelyï¼U=22.500, P<0.05ï¼; The average pre-and post-operative VAS score was ï¼5.60±1.26ï¼ points and ï¼2.50±1.27ï¼ points, respectivelyï¼U=4.500, P<0.01ï¼. As for Kubota drinking test, the rating was between 1-2 two weeks postoperatively. After relieving the compression, there was no obvious choking and coughing in drinking water. During the follow-up period ï¼range: 6-24 monthsï¼, the surgical wound healed completely, and the symptoms of systemic tuberculosis poisoning disappeared. No obvious residual cavity or effusion was found in the parapharyngeal space by CT examination, nor was any protruding tissue in oropharynx. The edema of soft tissue surrounding the operational area disappeared, and the enlarged lymph nodes were significantly reduced. No sign of liquefaction, necrosis, suppuration or recurrence was observed. Conclusion:Surgery using transcervical approach effective in treating cervical lymph node tuberculosis with parapharyngeal space abscess.