Problem: The purpose of this investigation is to outline strategies for assessments of neck swellings and management of more common swellings encountered in young children.
Introduction: Swellings of the neck are a common diagnostic challenge for physicians. A basic understanding of the anatomy of neck structures and a systematic way would enable a correct diagnosis in a quick and safe way. Familiarity with pathology and a thorough examination technique will allow for a working diagnosis on occasion.
Hypothesis: This study will ascertain the shape and size of swelling in the neck in relationship to surrounding tissues such as skin, muscles, trachea and hyoid bone are factors in determining the arrival of a sensible diagnosis in young children.
Research: Children are likely to present a short history of either enlarged tender lymph nodes, suggesting and infective or inflammatory process, or multiple small non-tender nodes, suggesting a viral infection. Long-standing cystic swellings in children suggest a congenital problem, possibly cystic hygroma. Thyroid swellings in children are uncommon, but 50% of them are malignant when they do occur. Other common clinical conditions in adolescents include:
• Thyroglossal cyst, presenting as a painless swelling at or below the level of the hyoid bone, which elevates on tongue protussion
• Branchial cyst, presenting as the anterior border of the sternomastoid muscle below the jaw, there is usually rapid painless development of the swelling although secondary infection and inflammation may occur
• Plunging ranula, a cystic swelling in the submandibular region due to extravasation through the mylohyoid muscle of mucoid saliva from a disrupted sublingual gland in the floor of the mouth.
Adolescents can also present with acute inflammatory lymphadenopathy in the jugulodigastric region and...
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