ENT Benign Neck Masses
ENT Benign Neck Masses
ENT Benign Neck Masses
Neck Masses
Thyroid nodules
Cervical lymphadenopathy
Thyroglossal duct cyst
Thymus gland anomalies
Plunging ranula
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Ultrasound
Distinguish solid from cystic lesions
Angiography
Evaluate vascularity and blood supply of mass, status
of carotid artery
CT/MRI
-
Differential Diagnosis
Patient age
0-15
years
Freq of dse
Inflammatory
groupings
Congenital
Neoplastic
Traumatic
Location
Congenital
Inflam
Neoplastic
Midline/Anteri
or
Thyroglossal
duct cyst
Dermoid
Laryngocele
Adenitis
Thyroid
Lymphoma
16-40
40+
Inflammatory
Congenital
Neoplastic
Traumatic
Neoplastic
Inflammatory
Congenital
Traumatic
Anterior
Posterior
triangle
Branchial cyst
Thymic cyst
Sialadenopath
y
Adenitis
sialadenitis
Metastatic
Lymphoma
Lymphangioma
Adenitis
ENT
LARYNGOCOELE
Abnormal dilation or herniation of saccule of larynx
MC submucosal laryngeal mass lesion
Common in players of wind instrument
Enlarges when the patient exhales or blows
BRANCHIAL CYST
MC congenital mass in the lateral neck
o
Anterior triangle
Vestigial remnant of the fetal branchial apparatus
Presents as bulge or sinus tract opening at the
border of SCM
Internal tract or opening of cyst
o
MC: 2nd branchial cleft anomaly
First Branchial Cyst
Type I
Parallel to EAC
Pretragal, post auricular
Connection with TM or malleus>incus
Surgical excision
Type II
Second
-
PLUNGING RANULA
Simple ranula unilateral oral cavity cystic lesion
Plunging ranula pierces the mylohyoid muscle
o
There is submandibular mass
Cyst aspirate
Tx: Excision
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3 causes
o
Viral
adenovirus
Bacterial
THYROID MASS
Common cause of lymph in the neck
Extremes of ages will point to malignancies
Clinical hx
o
Age
o
Gender
o
Family history
o
Previous thyroid disease
o
Symptoms of compression and rapid growth
o
Hx of prior radiation exposure (papillary
type)
PE
o
Normal thyroid gland difficult to palpate
o
Firm discrete nodules more likely malignant
than diffuse or cystic swellings
o
Abnormal of vocal cords function or
presence of palpable lymph node
->malignancy
DX evaluation
o
Thyroid function test (TSH, FT3, FT4)
o
Thyroid scan- determine function of gland
and determine if nodule is hot or cold
o
UTZ
o
CT scan
o
FNAB (direct test)