Presentation of a case of cervicofacial actinomycosis after orthognathic surgery.
A 32-year-old male underwent bimaxillary orthognathic surgery at another clinic. Several weeks after surgery, the patient developed a right lateral mass in the neck with intermittent signs of local inflammation. Cervical imaging suggested a solid or vascular tumor. The cytology revealed lymphocytosis.
Two years after the index intervention, surgery performed through a Risdontype cervical incision revealed a granuloma in the lower right submaxillary cell with a fistula to the mandibular angle. The pathology report was consistent with chronic abscess with actinomyces colonization.
Early diagnosis of cervicofacial actinomycosis is difficult and only 10%of cases are detected at onset. Although uncommon, cervicofacial actinomycosis should be considered in patients with orthognathic surgery who develop a cervical mass in the weeks after surgery.