Clinical study of tuberculosis in the head and neck region-11 years' experience and a review of the literature

Abstract

Tuberculosis (TB) is an infectious disease and major health concern. Head and neck tuberculosis (HNTB) is relatively rare, but can arise in many regions, including the lymph nodes, larynx, oral cavity and pharynx. We retrospectively reviewed the clinical records of 60 patients diagnosed with HNTB in our department between March 2005 and January 2016. A review and summary of previous HNTB articles published in PubMed since 1885 was also performed. The subjects consisted of 17 males and 43 females, and the average age of patients was 45 ± 14.67 years. The major clinical presentation was a lump or swelling, followed by an oral ulcer and skin fistula. The most common site of tuberculosis was in the cervical lymph node. Three patients also suffered from a malignant tumor in the head and neck region. A total of 980 papers involving 5881 patients were included in our literature review. The included subjects ranged in age from 15 months to 100 years with a male-to-female ratio of 1.5:1. The larynx (38.92%), cervical lymph nodes (38.28%) and oral cavity (9.92%) were the three most common development sites. 465 patients were positive according to a HIV test, and 40 patients had comorbidities with different types of tumors. Head and neck tuberculosis should always be considered during a differential diagnosis for lesions in the head and neck region. Early diagnosis and treatment can greatly enhance the therapeutic effect and patients' quality of life.

Fig. 1

Number of patients by year—our series

Fig. 2

Publication timeline and reporting department from the literature review. a Number of publications by year. b Distribution of the reporting department. ENT ear-nose-throat; OMFS oral and maxillofacial surgery

Fig. 3

Geographical distribution of HNTB patients from the literature review

Fig. 4

Annual prevalence of HNTB by continent from the literature review

Fig. 5

Organ distribution of HNTB by continent from the literature review

Fig. 6

Clinical material of a HNTB patient—the case report. a Frontal photograph. b–d Computed tomography results. e Panoramic tomography results. f Liquid aspirate from the lesion site. White arrows: HNTB lesion; Red arrow: mandibular involvement

Fig. 7

Follow-up material of the HNTB patient—the case report. a–c Computed tomography results after two months of treatment. d–f Computed tomography results after ten months of treatment. g Frontal photograph after ten months of treatment. Red arrow: mandibular involvement