CLASSIFICATION OF NECK SWELLING
About 50% of the neck swellings are of thyroid swelling or goiter. Other swellings are of congenital, developmental, infective, salivary gland diseases, neurogenic & parapharyngeal space tumours.
Mid line swellings-
· Thyroglossal duct cyst/ thyroglossal duct sinus.
· Sublingual dermoid cyst/ dermoid cyst.
· Plunging ranula.
· Thyroid swelling at isthmus.
· Subhyoid bursa.
· Pretrachial, prelaryngeal lymphnodes.
Lateral neck swelling-
· Thyroid swelling or goiter.
· Lymph node enlargement- non-specific cause.
· Lymphangiomas / cystic hygroma.
· Branchial cyst/ branchial sinus.
· Salivary gland swelling- parotid swelling
Submandibular gland swelling.
· Lipoma .
· Sebaceous cyst.
· Laryngocele / pharyngeal pouches.
· Carotid body tumour/ schwannoma .
THYROGLOSSAL DUCT CYST-
· Commonest mid line neck swelling.
· Thyroglossal cyst developes due to persistence of thyroglossal duct.
· Age of presentation is 4 months – 70 years.
· 90% in mid line, 10% are in lateral position.
· Presents as mid line painless cystic swelling which moves on swallowing & as tongue protrusion.
· Inves.- Thyroid scan –to know functioning thyroid tissue.
F N A C.
· Treatment- SiS-trunk operation.
· Midline swelling that do not move on deglutition or protrusion of tongue.
· Common sites are – root of nose, sublingual, external angular, post auricular.
· Three types of dermoid cysts-
A) Epidermoid cyst- lined with squous epithelium & contain chesssy
B) True dermoid cyst- lined with sq. epithelium & contain hair, hair follicles, sebaceous gland & sweet glands.
C) Teratoid cyst- lined with sq. or respiratory epithelium and contain ectodermal, endodermal or mesodermal elements is teeth, nail , thyroid tissue.
· Treatment- complete excision.
CYSTIC HYGROMA/ LYMPHANGIOMAS
· There are 3 types of lymphangiomas – simpl , cavernous and cystic hygroma.
· Simple and cavernous lymphgangiomas occur in the lip,tongue check etc.
· Cystic hygroma arises mainly in the neck and may extend to the floor of the mouth,check,tongue,parotid and ear canal.
· Most of these tumours are present at or shortly after birth.
· Cystic hygroma can extened to the mediastinum causing stridor.
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