US-guided needle aspiration and catheter drainage as an alternative to open surgical drainage for uniloculated neck abscesses

PURPOSE: To prospectively evaluate the effectiveness of ultrasound (US)-gui ded needle aspiration and catheter drainage as an alternative to open surgi cal drainage of uniloculated neck abscesses. MATERIALS AND METHODS: Fifteen consecutive patients (11 female, four male; age range from 18 days to 78 years, mean 42.5 y +/- 22.4) diagnosed with de ep neck infections associated with uniloculated neck abscesses were treated . The patients were originally scheduled for surgical incision and drainage after a period of unsuccessful treatment with antibiotics. US-guided needl e aspiration (in 10 patients) and US-guided catheter drainage (in five pati ents) were performed under local anesthesia. Open surgical drainage was per formed when US-guided drainage procedures failed. RESULTS: Surgical open drainage was avoided in 13 of the 15 patients (87%). An average of 6 mt of pus was obtained in patients in the needle aspiratio n group and 140 mt of pus was drained by catheter. One patient had a recurr ent pyogenic lymphadenitis at the same location and was treated successfull y by repeated needle aspiration. No complications occurred in this study. CONCLUSION: In a selected group of patients without imminent airway obstruc tion, most uniloculated neck abscesses may be managed initially by US-guide d needle aspiration and catheter drainage before resorting to open surgical drainage.