NECK SWELLINGS
Neck swellings are a very common presentation. In adult approximately 80% of non thyroid neck masses are neoplastic. In children under 15 years 90% of neck masses are benign & of these 55% are congenital.
It can be congenital or acquired.
Congenital neck swelling are mostly cystic like lymphangimas, cystic hygroma, dermoid cyst, thyroglossal cyst, branchial cyst which are treated by complete surgical excision.
Acquired neck swelling include non inflammatory and inflammatory swelling like lipomas, sebaceous cyst treated by surgical excision.
Inflammatory neck swelling include lymphadenitis, abscesses.
Lymphadenitis can be acute or chronic depending on duration. Treatment includes supportive and antibiotic therapy.
Neck abscesses includes superficial soft tissue abscess, retropharyngeal, parapharyngeal, sumandibular abscesses. Treatment is incision and drainage with antibiotic therapy
It can also be due to thyroid gland. They can be diagnosed by Ultrasonography, Fine needle aspiration, computed tomography and radionucleotide imaging which can be treated conservatively or may require surgical excision. It may require radiotherapy or chemotherapy in case of malignancy.
Neck swelling can present with symtoms like dysnoea or dysphagia. In such cases exact cause has to be found out with help of computed tomography and direct laryngoscopy, and fibre-optic endoscopic examination of upper aero-digestive tract is to be considered.
