What is it?
This type of surgery may take on many forms. It may be the removal of a single lump or the removal of all of the lymph nodes from one side of the neck (called a neck dissection). It may be done for cancers in the region, or it may be done for benign lumps.
How is it done?
Neck surgery is done under general anaesthesia. Depending on the operation’s aims and the extent of surgery required, it might take 30 minutes up to 3 hours. These operations require an incision on the neck, so there will be a scar on the neck (see here for advice about scar management). It is important to be aware that several important nerves in the neck may be at risk during this type of surgery. Hence these are best performed by an experienced head and neck surgeon. The nerves that go to the shoulder, the tongue and the corner of the mouth are all close by where these operations occur. In addition, the main blood vessels to and from the brain pass through the neck and may be close to the site of your surgery.
What happens after surgery?
Neck surgery usually requires up to 1-2 nights in the hospital. You will have a drain in the neck that collects any excess fluid. Once this drain dries up, it is removed, and then you are safe for discharge from the hospital. You may also be discharged with the drain and regular dressing will then be done in the out-patient department.
Causes of neck lumps
- A congenital or developmental abnormality
- Infection by bacteria, viruses or other organisms
- Inflammation due to various reasons, which may involve the thyroid or salivary glands
- A benign (non-cancerous) tumour may arise from any neck structure, including nerves, fat, muscles, blood vessels, thyroid or salivary glands.
- A malignant (cancerous) tumour that may be spread from a skin cancer, mouth or throat cancer to the lymph glands in the neck
Lymph glands
- The head and neck region contains many lymph glands (also called lymph nodes), part of the immune system fighting infection.
- Neck lumps are often due to swollen lymph glands.
- Lymph glands are normally small, soft and non-tender lumps.
- Lymph glands may increase in size due to infection or when there are swollen by abnormal cells.
- Lymph glands may also become painful or tender.
- In children, neck lumps are more frequently benign (non-cancerous)
- The rate of malignant (cancerous) lumps increases with age.
Surgery to remove a neck lump
- Surgery to remove a neck lump depends on the location, size, and characteristics of the lump.
- In general terms, the incision is made along the lines of the neck's skin folds, exposing the area.
- The neck structures are carefully identified, and the lump and the neck lymph glands are removed as required based on the diagnosis.
- The lump is then forwarded for histopathology assessment to confirm the diagnosis.
- The incision is usually closed with absorbable sutures around a silicone drain tube.
- The drain tube helps prevent fluid accumulation and is usually removed a few days after surgery.
Dr. SHALINA RAY is a highly trained ENT specialist with special training in head and neck surgery for treating all neck tumours
FAQs
Neck lumps can develop due to enlarged lymph nodes, thyroid nodules, salivary gland disorders, congenital cysts, benign tumors, infections, or, in some cases, cancer. A thorough evaluation is necessary to determine the exact cause.
No. Many neck lumps can be managed with medication or observation, depending on the underlying cause. Surgery is recommended only when it is necessary for diagnosis, symptom relief, or treatment of the condition.
Your ENT specialist may recommend a physical examination, ultrasound, CT or MRI scan, blood tests, or a fine-needle aspiration (FNA) biopsy to identify the cause and plan appropriate treatment.
FNA is a minimally invasive procedure in which a thin needle is used to collect cells from a neck lump for laboratory analysis. It helps determine whether the lump is benign, inflammatory, or requires further evaluation.
A neck lump that persists for more than two to three weeks, increases in size, feels hard, or is associated with difficulty swallowing, voice changes, unexplained weight loss, or persistent pain should be evaluated by an ENT specialist promptly.
Most neck lump surgeries are performed under general anesthesia to ensure patient comfort and allow the surgeon to safely remove the lump or obtain the necessary tissue for diagnosis.
The incision is usually planned within natural skin creases whenever possible to make the scar less noticeable. The appearance of the scar also depends on the size and location of the lump and individual healing.
Recurrence depends on the underlying diagnosis. While many benign lumps are completely cured after removal, some conditions may require ongoing follow-up to monitor for recurrence or manage the underlying disease.
Biopsy results are generally available within a few days, although the exact timeframe may vary depending on the type of tissue analysis required and the pathology laboratory.
Early diagnosis helps identify the exact cause, allows timely treatment, and improves outcomes, particularly when the lump is related to an infection, thyroid disease, or a head and neck tumor.
