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How to Deal with a Mass around the Head and Neck Area?

       The Attending Physician Dr. Yu Yu-Lin from the Department of Otolaryngology of Taipei City Hospital Renai branch has pointed out that there are various causes for head and neck masses, which can include cold and flu, sinusitis, tonsillitis, salivary adenitis, lymphadenitis, thyroiditis, thyroid nodules, lipomas, salivary gland tumors, thyroglossal duct cyst, nasopharyngeal cancer, oral cancer, laryngeal cancer and other causes. Accurate diagnosis requires detailed patient history taking and a physical examination.

       Firstly, to exclude infections related to head and neck mass. If the mass feels “red, swollen,  hot and painful” upon palpation, and it forms within a few days to a few weeks, combined with fever, tachycardia, upper respiratory tract symptoms, toothache, insect/mosquito bite, animal contact or traumatic wound, then the mass is likely to be caused by an infection. Oral or intravenous injection with antibiotics should be given depending on the clinical condition. In severe cases such as deep neck infections resulting in breathing difficulty, then artificial airway and excision for pus drainage may be required. Symptoms should generally alleviate between 2-4 weeks.

       Benign lesions such as a thyroglossal duct cyst, lipoma, branchial cyst, preauricular sinus, and benign parotid gland tumor can mostly be removed by surgical excision. Cervical lymphadenitis such as Kikuchi’s disease can be treated with steroid therapy. Ultrasound imaging and pathological diagnosis are used to determine the size of nodules in the thyroid gland diseases and determining the subsequent treatments. Treatment for thyroid gland diseases includes oral thyroxine, radiofrequency ablation or thyroidectomy. Malignant tumors, on the other hand, follow the corresponding treatments depending on the site of origin and staging. The majority of treatments involve surgical excision, chemotherapy or radiation therapy.