Ultrasound guided transcervical drainage of tongue base abscess

Importance: Infected vallecular cysts should first be treated conservatively and if airway is compromised surgical treatment is considered. Objective: The aim of this study was to determine the feasibility and safety of transcervical aspiration of an infected vallecular cyst. Design: A retrospective review of a novel technique that has been used for drainage of vallecular cyst abscesses for 5 years (2012 to 2017). Setting: Galilee Medical Center affiliated to Azrieli Faculty of Medicine. Participants: Consecutive patients who underwent ultrasound guided percutaneous vallecular cyst drainage. Main outcome & measures: Medical records were reviewed to identify patient characteristics, symptoms, and outcomes. Results: During 2012–2017, seven patients underwent transcutaneous ultrasound-guided drainage of a tongue-base abscess as an in-hospital office procedure. In all patients the technique described above was feasible. About a month after the procedure, patients underwent surgical marsupialization of the cyst under general anesthesia. Conclusions and relevance: Ultrasound guided transcutaneous needle drainage of a base of tongue abscess is possible as it may achieve palliation and obtain material for culture. In this first-described series we show this technique's feasibility. Physicians should be familiar with this technique as it can easily be done under ultrasound guidance in the clinic using local anesthesia, and culture may be obtained, airway obstruction relieved, and recovery facilitated.