Background: Paediatric neck masses are one of the common surgical conditions presenting to the pediatric surgical ward and clinics in many centers worldwide and contribute significantly to high morbidity and occasionally mortality. There is paucity of information regarding pediatric neck masses in our setting. This study was conducted to establish the patterns of pediatric neck masses and to identify predictors of outcome in our local setting.
Methodology: This was a prospective cross-sectional hospital based study done in children aged ten years and below with neck masses for a five months period. Statistical data analysis was done using SPSS version 17.0.
Results: A total of 148 patients were studies. Their age ranged from 2 months to 10 years (median 3 years). The male to female ratio was 2.5:1. Inflammatory lesions were the most frequent cause of neck masses accounting for 43.9% of cases. The median duration of illness was 2 years. Except for the neck mass, 72 (48.6%) of the children had clinically stable health condition on presentation. The posterior triangle was commonly involved in 118 (79.7%) patients. Eight (5.4%) were HIV positive. The majority of patients (95.9%) were treated surgically. Postoperative complication rate was 30.4% and surgical site infection was the most frequent complication in 37.5% of cases. The median length of hospital stay was 10 days and was significantly longer in patients with malignant masses and those with surgical site infection (P < 0.001). The overall mortality rate in this study was 8.1% and it was significantly associated with malignant masses, associated pre-existing illness, late presentation, HIV positivity, low CD4 count, high ASA class and presence of surgical site infections (P < 0.001). The outcome of patients on discharge was excellent as more than 90% of patients were successfully treated and discharged well.
Conclusion: Pediatric neck masses are among the common surgical conditions in our setting and some of them are malignant. We advocate early surgical consultation and thorough histopathological examination of neck masses in children.