Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Pediatric Otolaryngology

Nontuberculous Mycobacterial Cervical Lymphadenitis: Tips and Pearls for Headache-Free Management

Tuesday, October 3, 2023
1:00 PM - 2:00 PM East Coast USA Time
Location: 207CD

    Moderator(s)

  • Mathieu Bergeron, MD

    Associate Professor
    Sainte-Justine Hospital
    Montréal, QC, Canada

    • Panelist(s)

  • Josh P. Wiedermann, MD

    Assistant professor
    Pediatric Otolaryngology - Head and Neck Surgery Mayo Clinic Rochester
    Rochester, MN, United States

  • HN

    Heather C. Nardone, MD

    Clinical Associate Professor of Otolaryngology and Pediatrics
    Sidney Kimmel Medical College at Thomas Jefferson University
    Wilmington, DE, United States

  • Jennifer D. McLevyBazzanella, MD

    Associate Professor
    University of Tennessee Health Science Center
    Ardsley, NY, United States

Disclosure(s):
Mathieu Bergeron, MD: No relevant relationships to disclose.
Josh P. Wiedermann, MD: No relevant relationships to disclose.
Heather C. Nardone, MD: No relevant relationships to disclose.
Jennifer D. McLevyBazzanella, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Nontuberculous mycobacterial lymphadenitis is a common cause of subacute and chronic cervicofacial masses in children under 5-years-old. The natural history of such disease involves slowly enlarging lymphadenopathy of the cervicofacial region. Most patients will not have systemic symptoms and the infection itself will remain isolated to one region. With time, the classic violaceous skin discoloration can occur as the infection extends beyond the lymph node capsule. The infection can progress to a draining fistula as the latest stage.

There is no universally accepted work-up or treatment algorithm. Common work-up options involve lab tests, ultrasound, and biopsy. Current treatment options include observation, antibiotic therapy, curettage, fine needle aspiration, incision and drainage and complete surgical excision. Each of these options come with benefits and possible complications. The management decision is highly medical center dependent as no consensus exist. Several grey zones exist for this topic. What are, if any, are the highest yield tests? How can we predict spontaneous resolution? Who should undergo surgery and if indicated, does complete excision of involved nodes provide better outcomes than curettage? Should antibiotics be given at the same time? Should adjacent cervical nodes be addressed? Nontuberculous mycobacterial lymphadenitis (NTML) is a common cause of subacute and chronic cervicofacial masses in children under 5 years of age

This session will cover the work-up and management options of nontuberculous mycobacterial cervicofacial lymphadenitis and will help the clinician to decide which therapy might be more appropriate for each patient. This panel of experts will be composed of 3 pediatric otolaryngologists skilled in the management of such patients.

OUTCOME OBJECTIVE 1: Describe the presentation and workup of nontuberculous mycobacterial cervicofacial lymphadenitis

OUTCOME OBJECTIVE 2: Compare the current management options of nontuberculous mycobacterial cervicofacial lymphadenitis

OUTCOME OBJECTIVE 3: Explain the benefits and downsides of each treatment modality

BACKGROUND STATEMENT: Urgent need for a review of current literature and trends, to help clinicians counsel parents and caregivers regarding management of nontuberculous mycobacterial cervical lymphadenitis