OTORHINOLARYNGOLOGY

BALL IN THE NECK

It is not the sensation of a lump in the throat, a psychosomatic manifestation of contracture of the muscles of the pharynx.

We will distinguish the balls located in the middle of the neck and those located on the lateral sides of the neck.

The balls in the middle of the neck suggest a thyroglossal cyst or thyroid swelling.

– The thyroglossal cyst of congenital origin presents as a rounded, regular swelling, usually painless, of quite ordinary appearance. It is due to the dilation of a duct that has persisted abnormally during the development of embryonic life. The cyst can become infected, shrink, grow again, and will need to be removed. The intervention is relatively delicate, because it must remove the cyst, but also the hyoid bone which, left in place, exposes to recurrence.

– Thyroid swelling: a lump is called a goiter or nodule. It does not cause pain, but sometimes a simple discomfort, when the volume becomes important. Should it be removed or is it possible to treat it medically? Only radioactive iodine scintigraphy will provide the solution: it sometimes shows that the thyroid gland is making excess thyroid hormone and, in this case, medical treatment is possible; if, on the contrary, this lump no longer secretes thyroid hormone, the so-called cold nodule is not accessible to medical treatment and requires surgical intervention.

The lateral balls of the neck are reminiscent of a ganglion or thumefaction of a salivary gland.

The ganglia:

The presence of lymph nodes in the neck is linked to three kinds of causes:

– reaction of the lymph node in the neck linked to inflammation or infection in the vicinity; this is the most frequent case, angina or nasopharyngitis for example.

– invasion of the ganglion by cancer cells, cancers for example.

– tumor proliferation of the lymph node tissue itself of the malignant lymphoma type.

Precise medical management leads to a diagnosis.

Salivary swelling

– The parotid is located below and in front of the ear. The presence of a stone, but above all, of a benign tumor causes an increase in the volume of the parotid. These diseases require long and careful surgery due to the passage of the facial nerve inside the gland.

– The submandibular gland is placed under the lower jaw. The presence of a stone prevents the normal flow of saliva and thus causes dilation of the gland. The disease progresses by painful outbreaks caused by meals; gradually, the saliva is eliminated, and the gland regains its normal volume. Surgical removal of the gland is almost always necessary. the excision of one or two salivary glands does not cause functional discomfort, and no dryness of the mouth, the other salivary glands easily compensating for the deficiency of one or two of them.

Copyrigth photo : Par © Nevit Dilmen, CC BY-SA 3.0,

Bibliography : Atlas of Head and Neck Surgery: Expert Consult by James I. Cohen & Gary L. Clayman 

BALL IN THE THROAT

Very frequently felt and often poorly defined, the sensation of a lump in the throat is a factor of anxiety. When this lasts, a careful examination is always necessary in order to formally rule out a local lesion.

This being ruled out, we will retain this disorder as a modification of the sensitivity of the region, also called pharyngeal paresthesia.

It may be an impression of a foreign body, a knot in the throat, sometimes accompanied by difficulty in swallowing saliva. On the other hand, a very positive element, the meals go normally, and even make the discomfort disappear. It is not a dysphagia. This discomfort is due to a contracture of the musculature of the pharynx. The progression of the food bolus forces the relaxation of these muscles and makes the contracture disappear. Such a disorder is often related to cancerophobia, to which sedatives and tranquilizers provide temporary improvement. People who complain about it do describe this kind of symptom, often for years.

Local procedures are sometimes useful, such as cryo-surgery, or electro-coagulation of certain tonsil crypts. However, psycho-therapeutic support remains the important element of treatment when the disorders are old or very troublesome, and in particular if there are cases of cancer in the family.

CERUMEN CAP

It is by cleaning your ear with your pinky finger, and not with a deeply inserted cotton swab, that you will avoid the creation of an earwax plug. This can cause a blocked ear sensation, hearing loss, ringing. A simple washing of the ear with lukewarm water allows the plug which hid the eardrum to be evacuated.

Copyright photo : Par Didier Descouens — Travail personnel, CC BY-SA 3.0

EAR BUZZING

Ringing in the ears, also called whistling or tinnitus, is a sensation of noise of extremely variable character and perceived in one or both ears, or sometimes poorly located in the head. It may resemble the sounds of cicadas, like a jet of steam; very often it is compared to the beating of the pulse.

He may be isolated; the most common causes are: earwax plug, arterial hypertension, sound trauma. Even if the sound trauma happened only once and a long time ago, the buzzing may start right now and never stop again.

Very often, no cause is found, the buzzing accentuated by fatigue or nervousness, attenuated by rest, causes a very variable discomfort. It is well tolerated when it is perceived only in silence, and masked during the day when the sound environment is sufficient.

Sometimes the ringing in the ears is not isolated, but is accompanied by deafness and / or dizziness. Sometimes, treating these symptoms can make the ringing sound go away.

Copyright photo : Pixabay

Bibliography : Tinnitus (Springer Handbook of Auditory Research 44) by Jos J. Eggermont, Fan-Gang Zeng,

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