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Throat and Neck

The throat and neck contain the airway, the swallowing passage, the thyroid and salivary glands, and a dense network of lymph nodes. Symptoms arising here range from the entirely benign to the serious, and the two can be difficult to tell apart without proper examination.

The purpose of a specialist assessment is to establish which you are dealing with, comprehensively and definitively.

CONDITIONS COMMONLY SEEN

  • Neck lumps of any kind, in adults and children
  • Difficulty swallowing (dysphagia) or a sensation of food sticking
  • Globus — persistent sensation of a lump in the throat without difficulty swallowing
  • Recurrent tonsillitis and enlarged tonsils
  • Peritonsillar abscess (quinsy)
  • Persistent sore throat
  • Thyroid swellings and nodules
  • Salivary gland swelling, stones and infection
  • Laryngopharyngeal reflux — throat clearing, catarrh, cough and hoarseness
  • Head and neck cancers of the mouth, throat, larynx, thyroid and salivary glands

ASSESSMENT

Examination covers the mouth, throat and a systematic palpation of the neck. Flexible nasendoscopy allows the areas of the throat that cannot be seen by looking through the mouth — the nasopharynx, the tongue base and the larynx — to be inspected directly in clinic.

Where a lump requires further characterisation, ultrasound scanning and fine needle aspiration cytology (FNAC) are arranged, usually together, allowing a tissue diagnosis without open surgery. Further imaging and biopsy are organised as required.

TREATMENT

  • Medical management of reflux, infection and inflammatory conditions
  • Tonsillectomy for recurrent tonsillitis or obstruction, performed using Coblation to reduce bleeding and postoperative pain
  • Drainage of peritonsillar abscess
  • Excision and biopsy of neck lumps
  • Salivary gland surgery
  • Head and neck cancer surgery, with management coordinated through a multidisciplinary team
  • Onward referral to endocrinology, oncology or maxillofacial services where that is the right pathway

SYMPTOMS THAT SHOULD NOT BE DELAYED

Certain symptoms warrant assessment without waiting, particularly in adults that are current or former smokers and/or heavy drinkers:

  • A neck lump that has been present for more than three weeks
  • Hoarseness persisting beyond three weeks
  • Difficulty or pain on swallowing that is getting worse
  • A persistent one-sided sore throat or earache with a normal-looking ear
  • A mouth ulcer or lesion that has not healed within three weeks
  • Unexplained weight loss alongside any of the above

Most patients with these symptoms turn out not to have cancer. The point of prompt assessment is to establish that quickly, and to act without delay in the minority for whom it matters.

Request an appointment: +357 24 840840