Specialisms of The London Head and Neck Clinic

Although we cover the whole range of Head and Neck disorders, the following list runs through, in alphabetical order, some of the more common ones:

Basal Cell Carcinoma - the commonest site is on the face, since they are usually caused by sun exposure. the treatment can be with laser, cytotoxic creams, surgery or radiotherapy.

Branchial cyst. Classically occurs in the 20's, they present as lumps in front of the upper part of sternocleidomastoid muscle. They may become recurrently infected. They are relatively easy to remove surgically.

Carotid body tumour. Very rare, they present as a pulsatile lump half way down the lateral neck. Treatment can be with radiotherapy and/or surgery.

Cancer. Head and Neck cancer is the 9th commonest of all cancers. It includes thyroid cancer. These tumours often present early, and there is therefore a reasonably good cure rate, up to 95% for early laryngeal cancers. The treatment can be with laser removal, surgery, or chemoradiotherapy. The National Institute for Clinical Excellence has set out guidelines for when patients should be seen at a Head and Neck Clinic due to suspected cancer.

The suggested symptoms to prompt referral are:

Hoarseness, swallowing problems, pain, ulcers, neck lumps, nose blockage, ear pain, unexplained loose teeth, eye proptosis, white or red patches in the mouth. The index of suspicion is further raised by the presence of additional risk factors, such as smoking, alcohol consumption and age >45. Based on “Referral guidelines for Suspected Cancer” London; Department of Health, 2000.

Cystic Hygroma. Commonly occurs in children, the treatment is by surgical removal, although it it is sometimes hard to completely cure them. They are benign lymphangiomas.

Dermoid tumour. Occurs in the midline, or along lines of embryonic fusion. Can become recurrently infected, the treatment is by surgical excision.

HIV. One of the conversion criteria for HIV positive patients developing AIDS is when they develop multiple neck nodes - persistant generalised lymphadenopathy.

Lipoma. Fatty lumps below the skin, often on the nape of the neck. Surgical removal unde local or general anaesthetic is usually curative.

Lymphoma. This cancer of the lymph glands commonly presents as a neck lump. The treatment usually involves surgical removal of the lump, or part of it, followed by chemotherapy.

Neck nodes. Can come up secondary to inflammation, such as tonsillitis. Persistant neck nodes may be as a result of secondary spread from a primary head and neck cancer. Some cancers, such as those of the post nasal space, can initially present as a lump in the neck. This is why all neck lumps need to be assessed by a surgeon competant in full examination of the ENT system.

Thyroid lumps. Can be benign or malignant. Most are part of multi-nodular change. Solitary solid nodules as found on ultrasound usually need to be removed. 20% of these are malignant.

Salivary gland. The main salivary glands are the Parotid and Submandibular glands. Most tumours occur in the Parotid gland, and most of these are benign. Other diseases, such as sialectasis, or duct stones, also occur. The treatment is usually surgical excision, although some submandibular duct stones can be treated by lithotripsy or basket removal.

Sebaceous Cyst. Intra-epithetlial cysts full of kerartinous debris. They can become infected and are are common around the ear. The treatment is by surgical removal, usually under local anaesthetic.

Shwannoma. A nerve sheath tumour, although rare, they are relatively more common in the vagus nerve in the neck, or the brachial plexus. The treatment is usually watch and wait in the first instance.

Tuberculosois. TB presents most commonly as a neck lump. Symptoms associated include night sweats, lethargy and anorexia. The treatment is with triple or quadruple antibiotic therapy.

If you wish to ask for advice or arrange an appointment, please telephone 0207 467 6190.

If you would like to email an enquiry, please email us: enquiries@londonheadandneck.com

Telephone: 0207 467 6190 Email: enquiries@londonheadandneck.com