THE HEAD AND NECK MANIFESTATIONS OF TUBERCULOSIS
1Gaziosmapaşa Üniversitresi Tıp Fakültesi, KBB ve Baş-boyun cerrahisi Anabilim Dalı, Tokat, Türkiye2Karaman Devlet Hastanesi, Karaman, Türkiye Objective: To analyze the head and neck manifestations of tuberculosis, to investigate the clinical features, diagnosis methods and to evaluate the treatment results.
Method: It is a retrospective analyzed trial, in which 27 head and neck tuberculosis patients diagnosed and treated in Gaziosmanpaşa University Medicine Faculty Hospital between 2005 and 2011.
Results: Twenty-seven head and neck tuberculosis patients were determined after investigation. The head and neck involvement regions were cervical lymphadenitis in 25 patients (92.6%), laryngeal tuberculosis in 1 patient (3,7%) and nasopharyngeal tuberculosis in 1 patient (3,7%). In 6 (22.2%) cases concomitant pulmonary tuberculosis was existing and all of the patients' chest radiographs had radiologic images of involvement. Pulmonary involvement was positive in both larynx and nasopharynx tuberculosis patients. The diagnosis was provided by tuberculosis culture positivity in 5 (18.5%) cases and tuberculosis PCR positivity in 3 (11.1%) cases. The diagnosis was made histopatholgically showing caseating granulomatous infection, obtained from fine needle aspiration biopsy or incisional/excisional biopsy in remaining patients. Fine needle aspiration biopsy was sufficient in 4 (14.8%) cases, as well as incisional/excisional biopsy was necessary in 15 (55.5%) cases.
Conclusion: In addition to cervical lymphadenitis, tuberculosis can cause a rare involvement in larynx and nasopharynx. In our series, open surgery with incisional/excisional biopsy (55.5%) was the most utilizied method in diagnosis. Tuberculosis is still common in our country and can be encountered as head and neck manifestations. The otolaryngolgists have to be careful and knowledgeable for early diagnosis and treatment.
Keywords : Tuberculosis, head and neck