Nightmare; neck swellings

Swelling in the neck area is one of the most common findings in otolaryngology practice. These swellings may be the result of a simple infection in the head and neck region in both adults and children, or they may rarely be a symptom of more serious disorders. In general, these swellings can be caused by infective (microbial), congenital (congenital) or tumoral causes.

There are approximately 300 lymph nodes in the neck region, whose sizes are around 3-5 mm, and it is not normally possible to feel them by hand. Infectious disease agents can directly settle in these tissues in the neck region and cause swelling in the lymph nodes, or infections in tissues such as the nose, sinuses, nasal passages, teeth and gums, oral mucosa, tonsils, salivary glands, vocal cords or thyroid gland can infect the lymph nodes in the neck. . During infection, lymph nodes enlarge and in general, lymph nodes larger than one cm are considered pathological. Such swellings are usually reactive, that is, they grow during defense in response to infection. These are usually painful and begin to decrease in size within a few days, either spontaneously or depending on the treatment applied. It may take 2-3 weeks for them to disappear completely, and although rare, they may remain at that size for life. Some infectious diseases, especially tuberculosis, may directly involve only the lymph nodes, and swelling may persist for months despite appropriate treatment.

Although congenital (congenital) neck swellings often appear in childhood, they can also occur in young adults. Some of these are present from birth. They arise as a result of abnormal formation during embryonic development in the mother’s womb. Some become evident following upper respiratory tract infection. Branchial cysts, thyroglossal cysts, hemangiomas, arteriovenous malformations, dermoid and epidermoid cysts are most commonly encountered. These are benign, but as they grow, they can pressurize surrounding tissues or become infected.

Although there are usually benign tumor masses in the neck that can be treated, malignant masses are also seen in considerable numbers. Benign or malignant tumors can develop from all tissues in the neck (such as lymph nodes, salivary glands, thyroid gland, muscle, vascular structures, nerves, etc.). The risk that a long-standing benign tumor in the neck may turn into a malignant tumor over time should not be neglected. Generally, malignant masses tend to grow rapidly, while benign ones tend to grow slowly. In adults, cancers that develop due to alcohol and cigarette use are frequently seen in the nasal, mouth, floor of the mouth, tongue, salivary glands, thyroid gland, nose-sinuses, throat and larynx regions. In children, cancers of unknown origin, such as lymphoma, leukemia, and rhabdomyosarcoma, can often be seen, and they can also be seen in middle and advanced ages.

When complaints of unexplained weight loss, night sweats, weakness, spitting blood, hoarseness lasting more than two weeks, difficulty in breathing or swallowing occur in a short time, it is necessary to be examined without delay. If the swelling in the neck area is present for more than 2-3 weeks and its size is getting larger, the pain is increasing, the number is increasing, or if there are many lymph nodes attached to each other, an otolaryngologist should be consulted.

prof. Dr. Mustafa KAZKAYASI