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Diseases of the neck
Swelling in the soft tissues of the neck can be attributed to various benign and malignant diseases. Tumors in the area of the pharynx can also be initially noticed via a swelling in the area of the neck, even before the actual tumor itself causes symptoms. For this reason, any new swelling in the area of the throat should be examined by a specialist so that an appropriate therapy recommendation can be derived from it.
The median or lateral cysts or fistulas of the neck are non obliterated residuals of embryonic development. Patients suffering from cysts or fistulas often notice a swelling on the lower jaw or on the side of the neck, dysphagia or an infection in the area. These types of cysts or fistulas are often seen in young children or young adults. Treatment involves total surgical removal. When removing a median cyst of the neck, a part of the hyoid bone should also be resected. This is easily done and does not result in increased complications after surgery. Multiple incisions are possible for this type of surgery, either below the lower jaw or diagonally along the neck above the sternocleidomastoid muscle.
Unilateral or bilateral swollen lymph nodes of the head and neck are often due to a viral or bacterial infection. The swollen lymph nodes can be painful or painless and usually result in a reduced general condition. The process of diagnosis involves a general examination, a neck ultrasound and blood samples. Treatment involves either anti-inflammatory medication or partial or complete surgical removal of the lymph nodes. After the treatment, regular follow-up ultrasound examinations are necessary.
There are a number of malignant diseases which cause swollen lymph nodes. Examples are Squamous cell carcinoma of the pharynx, larynx and skin. If this is the case, the lymph nodes are surgically removed and biopsies are taken of the phaynx and larynx via endoscopy. Lymphomas can also present with swollen lymph nodes of the neck.
Neck dissection is a surgical procedure to remove lymph nodes from the head and neck. The aim of the procedure is to remove lymph nodes from one side of the neck into which cancer cells may have migrated and to avoid spreading of the tumor. During surgery it is important to avoid injury to blood vessels and nerves in the immediate surrounding area. Surgical complications include infection, lymph fistulas and nerve damage which can result in trouble elevating a shoulder or altered function of the mimic muscles.
The soft tissue of the neck has hundreds of lymph nodes meaning that lymph node removal does not effect lymph drainage post surgery. Swelling is common immediately after surgery but usually resolves within days or weeks. Histopathological results of biopsies of removed lymph nodes usually take 7-10 days.
Benign neck masses include lipomas, fibromas, atheromas, haemangiomas or neurinomas. These masses may cause functional and aesthetic deficits and may increase in size. Diagnostic steps include an ultrasound followed by an MRI. Regular clinical examination and ultrasounds are recommended. In some cases surgical extraction may be necessary.
Inflammation of the neck affects all age groups and often occurs after a pharyngeal infection or an injury of the skin of the neck. Patients usually present with pain, dysphagia, fever and a reduced general condition. On clinical examination patients present with general inflammation of the skin which is painful to touch. Following the clinical examination patients undergo diagnostic imaging including ultrasound, CT and MRI scans. Small abscesses can be drained whereas larger abscesses need to be treated surgically.
Head of department
Univ.-Prof. Dr. med. Barbara Wollenberg
Director
PD Dr. med. Benedikt Hofauer
Prof. Dr. med.
Clemens Heiser
Attending debuty head
of department
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