Surgical causes of neck masses in pediatrics: management and outcome

Abstract

Background: Neck masses are common pathologies in pediatrics, surgery is considered the only line of treatment in most of neck lesions, and usually early intervention is recommended to avoid complications, The aim of our study is to evaluate the clinical and radiological presentations, the pathological findings, and the surgical outcome of neck lesions operated in our institution in pediatric age group.Methods: All pediatric patients presented at our pediatric surgery unit in the period from January 2017 to January 2018 by neck masses were included in this study, Patients with fistulae without underlying swellings and those with inflammatory lesions who responded to medical treatment and surgery wasn't indicated were excluded from this study. History taking, clinical evaluation, routine laboratory investigations and neck ultrasound were done in all cases, and Imaging studies (CT, MRI) were done in selected cases, all resected specimens were sent for histopathological examination, demographic data, duration of surgery, using of haemostatic devices, need of blood transfusion, duration of hospital stay, morbidity and mortality all were recorded and statistically analyzed.Results: In the majority of cases swelling was cystic in nature (69.4%), with lateral position in most of the lesions (61.2%), thyroglossal cyst proved to be the commonest (30.6%), followed by branchial cyst (22.4%). Clinical diagnosis with neck ultrasound was sufficient for diagnosis in most of the cases (55.1 %). Follow up of patients for 3 months in all cases with no mortality recorded and very low incidence of morbidity (6.1%).Conclusions: Neck swellings in pediatric population is common with wide range of differential diagnosis, with respecting anatomical and pathological backgrounds surgery has excellent outcome with very low incidence of morbidity.