- Swollen Lymph Node
- Branchial Cleft Cyst
- Thyroglossal Duct Cyst
- Dermoid Cyst
- Lymphatic Malformation
- Ranula
- Salivary Gland Mass
Swollen Lymph Node
ENT for Children may recommend surgery for a child who suffers from an infected or swollen lymph node (lymphadenopathy). The lymph nodes are small organs that are part of the immune system responsible to help fight infection and other diseases. The lymph nodes can enlarge from infections or inflammation.
Treatment for enlarged lymph nodes can include observation, antibiotics or surgery. If a node remains enlarged, becomes recurrently swollen or there is a concern for cancer your ENT for Children surgeon may recommend a biopsy or even removal of the lymph node for diagnosis of the problem and possible treatment.
Lymph node removal will be carried out under general anesthesia with a pediatric anesthesiologist. During the surgery, you pediatric ENT specialist will make an incision in the skin overlying the lymph node(s). The tissue is then separated to identify the problem lymph node(s). Then, he will remove the lymph node(s) and close the incision with dissolvable stitches and/or glue. Surgery is usually outpatient. We will send the lymph node(s) to be analyzed by a pathologist to determine what is causing the lymph node(s) to be enlarged.
Branchial Cleft Cyst
A branchial cleft cyst may appear in a child’s neck in the form of a cyst (mass) or a draining pit. The condition is congenital and present from birth; however, the cyst may not appear till later in childhood. Symptoms that are indicative of the condition include fluid drainage from the cyst opening or a painless mass in the side of the neck or face.
The long-term treatment for branchial cleft cysts is complete surgical removal. Your ENT for Children surgeon may recommend surgery to cure the problem and prevent infections. The surgery will be performed under general anesthesia with a pediatric anesthesiologist. During the surgery, your pediatric ENT will make an incision over the cyst or draining pit. The cyst and/or tract are dissected from the rest of the normal tissue and removed. The skin is then closed with dissolvable stitches and/or glue. Occasionally a temporary drain is left in the incision to help with wound fluid drainage. Your child may need to stay up to one or two nights in the hospital.
Thyroglossal Duct Cyst
A thyroglossal duct cyst is a result of the thyroglossal duct failing to involute (disappear) during fetal development. The condition results in a fluid filled cyst that forms in the middle of your child’s neck. This cyst can enlarge and/or become infected.
Your ENT for Children surgeon may recommend surgery to remove the cyst and duct to prevent future problems and infections. The surgery is performed under general anesthesia with a pediatric anesthesiologist. Your pediatric ENT will perform the surgery by making an incision in the skin over the cyst. The cyst and tract (duct) are then identified. A small, central portion of the hyoid bone (central bone in the neck, under the chin) is also removed in addition to the cyst and duct. This additional step ensured that the entire tract (duct) is removed to minimize the chance of the cyst coming back. The internal tissue and skin are then closed with dissolvable stitches and/or glue. A temporary drain may be left in the incision to help with wound fluid drainage. Your child may stay up to one or two nights in the hospital.
Dermoid Cyst
A dermoid cyst is a congenital mass that develops from skin that is trapped in the deeper tissues of the neck during embryonic development. The condition may appear as a lump or mass in the middle of the neck. The permanent treatment for a dermoid cyst is surgical removal.. Your ENT for Children surgeon may recommend surgery to remove cyst to keep it from enlarging or becoming infected. The surgery is performed under general anesthesia with a pediatric anesthesiologist. The skin is incised overlying the cyst. The cyst is then identified and removed. Occasionally a temporary drain is placed in the incision to help with wound fluid drainage. The incision is closed with dissolvable stiches and/or glue. This procedure is often outpatient but your child may need to stay one night in the hospital.
Lymphatic Malformation
Lymphatic malformations are congenital lesions that are present at birth; however, the mass may not enlarge or become evident until later in childhood. This condition results from an abnormal collection of lymph vessels that can enlarge. Theses lesions can affect the appearance of your child or cause breathing or swallowing problems.
Treatment for lymphatic malformations can be observation, surgery, sclerotherapy or both. Sclerotherapy is performed by a specially trained radiologist who injects medication within the lymph channels to scar then shut. Some lymphatic malformations cannot be treated with sclerotherapy and surgery may be required. Surgery for lymphatic malformations can vary tremendously due to the various different sizes and locations of these lesions. Your ENT for Children surgeon will discuss surgery with you in more detail based on your child’s specific lesion.
Rannula
A ranula is a saliva filled cyst that forms from a blocked duct in the saliva gland. These most commonly occur in the mouth under the tongue or as a soft neck mass under the jaw. When a ranula is diagnosed, surgery is commonly recommended to remove the cyst and blocked duct to prevent it from enlarging or coming infected.
Your pediatric ENT will perform the procedure under general anesthesia with a pediatric anesthesiologist. Depending on the location and size of the ranula, surgery may be performed through the mouth or by making an incision in the neck. If a neck incision is made, it is closed with dissolvable stitches and a temporary drain may be placed. Your child may need to stay one or two nights in the hospital.
Salivary Gland Mass
A salivary gland mass may occur in any of the three main saliva glands (parotid, submandibular or sublingual). Pediatric salivary gland masses can be benign or cancerous. Often imaging tests, such as a CT or MRI scan, and needle biopsies are performed to help identify the type of mass that is present. Almost all salivary gland masses require surgical removal. Benign masses need removal to prevent enlargement and cancerous masses need removal for treatment.
If surgery is required, your ENT for Children specialist will perform the surgery under general anesthesia with a pediatric anesthesiologist. The type of surgery and incision can vary depending on the type and size of the mass as well as which saliva gland is involved. If surgery is recommended, your ENT for Children surgeon will discuss the details with you based on your child’s specific lesion.