Head & Neck

The parotid gland is a major salivary gland located below and just in front of the ear. It may get swollen when there is infection or growth or any reaction of the gland. Swelling and inflammation of the gland is called parotitis. With appropriate medications and antibiotics (if indicated), the condition is curable completely. The gland may increase in size due to any growth inside. The growth may be cancerous or benign in nature. For any salivary gland swelling we do an ultrasound scan to check the nature of the contents inside. A swelling can have either liquid or solid contents. Depending on the contents the treatment will differ. In certain cases, we may need to ascertain the nature of the cells inside the swelling. For this a fine needle aspiration cytology (FNAC) study is done. A thin needle is inserted into the swelling and some cells are withdrawn. These are then studied in a lab and their nature determined. Thereafter we discuss the modes of treatment with the patient and offer the most appropriate treatment tailored for the condition and the patient.

Like the parotid gland, there are more salivary glands on each side of our head. These include sublingual and submandibular salivary glands. They are located beneath the tongue on either side. They open into the mouth via small tubes called ducts. These tubes can get easily blocked when the flow of saliva is not sufficient or when the mouth is excessively dry. Stasis of salivary secretions can result in the development of small stones inside these tubes. When such a stone is present, saliva gets accumulated when the patient starts chewing any food and causes significant pain. Sometimes these stones may be felt by hand when you rub the tube against your fingers. We may also ask for ultrasound of the gland to check the gland and tube structure. Depending on the location, size and associated inflammation, we have different methods for the removal of stones. The stones can be removed via thin endoscopes (sialendoscopy technique) without any cuts. Some stones are quite big that it may entail the removal of the entire gland itself. The submandibular gland which is quite big and whose duct runs against the gravity is the most susceptible for the development of such stones. We perform precise submandibular gland excision surgeries for gland stones. The surgery at our hands is a safe one with a minute cut and no complications.

Lymphangioma is a cystic swelling in the head and neck region. It is formed due to the enlargement of lymph vessels. Lymph is a fluid that is filtered out from the venous blood and eventually returns to the blood. It is involved in returning the tissue fluid back to the central circulation. In certain cases, the vessels may get engorged and swell up forming an external swelling. Lymphangioma can be treated surgically or using sclerosant therapy. Sclerosant therapy means the injection of certain special liquids into the swelling which cause a reduction in the size of the swelling. These liquids called sclerosants have to be injected a few times for the complete reduction of the swelling. Talk to us if you have a swelling in your head and neck region.

When the baby is in the uterus of the mother, a lot of growth and development occurs. From a single cell, a full-term baby is developed with all the anatomical structures. In this 9-month course, a lot of changes, divisions, joining and differentiations occur. Sometimes, a few of these embryological events may be slightly imperfect and lead to certain birth defects. One such defect is the faulty fusion of structures in the neck leading to branchial arch abnormalities. The branchial cyst is one such swelling in the neck region. It is painless but recurrent infections in the cyst may cause pain, abscess formation, pus and discharge. Infection is treated with antibiotics but the cyst warrants surgical removal. The prognosis is good. In experienced hands the surgery is perfect with no chance of recurrence. During the surgery it is imperative that one identifies all the elements of the cyst and removes each and every bit meticulously. We see that in some individuals the cyst is accompanied by a sinus tract. In that case, we need to meticulously remove the entire tract along with the cyst.

These are lymphatic tissue masses containing immune cells that fight against foreign cells or harmful antigens entering our immune system. They may swell up in response to infection or stress or tumour in the drainage area. These may be benign or sometimes may be a sign of cancer. Acutely painful lymph node and growing size are the symptoms when it is infectious. If swollen nodes are not accompanied by pain then they may be due to tumour. Swollen nodes may reduce spontaneously when the infection is controlled. However, in certain cases, a needle aspiration study or a biopsy may be needed to identify the underlying disorder which may be preventing the node from going back to its normal size. Tuberculosis is a common cause of enlarged lymph nodes in our country. It needs a clear diagnosis and a long-term treatment with medicines.