Common head & neck problems
- Neck lumps — most are reactive lymph nodes, but some are not. Evaluation usually combines exam, ultrasound, and if needed, a fine needle aspiration (FNAC).
- Thyroid nodules and goitre — many are benign and just need monitoring. Some need biopsy, some need surgery, and the modern approach is selective and evidence-driven.
- Salivary gland swellings — stones, infections, tumours. Submandibular stones at mealtimes are the classic story.
- Parotid (cheek) lumps — usually benign, but they grow slowly and rarely shrink, so surgical removal is often the right call, with careful facial-nerve preservation.
- Sleep apnoea and snoring with significant anatomical component — covered in detail on the Snoring & Sleep page.
How head & neck cases get worked up
Clinic exam, often with bedside ultrasound or a flexible nasendoscopy for upper-airway-related problems. Imaging — ultrasound, CT, or MRI — and FNAC for nodes or nodules when warranted.
Multidisciplinary input where it matters — endocrinology for thyroid issues, oncology for any malignant finding. You don't get sent away to figure that out on your own; the referral, the second opinion, the imaging — all coordinated.
Surgery, when needed
- Thyroidectomy and parathyroidectomy with nerve monitoring to protect the voice.
- Parotidectomy with facial nerve preservation — the cosmetic incision is hidden in the natural crease and behind the ear.
- Submandibular gland surgery and salivary stone removal — increasingly done minimally invasively where stone location permits.
- Neck lump excision biopsy when imaging and FNAC can't fully characterise a node.
- All head & neck cases get realistic, written pre-op counselling — exactly what the scar will look like, what the recovery week looks like, what the risks are. No surprises.
Frequently asked questions
I found a lump in my neck. How urgent?
Any neck lump persisting beyond two weeks, especially in an adult, should be checked. Most are benign reactive lymph nodes from a recent infection, but a small fraction need investigation. Earlier evaluation is always better.
Does every thyroid nodule need surgery?
No — most don't. The decision depends on size, ultrasound features, FNAC result, and how the nodule changes over time. Plenty of nodules just get monitored periodically and never need anything done.
Will thyroid surgery affect my voice?
It can, but with proper technique and intraoperative nerve monitoring, the risk of permanent voice change is well under 1%. Temporary mild changes are more common and usually settle within weeks. We discuss this in detail before surgery so you know exactly what to expect.
What's a parotid tumour and is it always cancer?
Parotid tumours are growths of the cheek salivary gland. About 80% are benign — most commonly pleomorphic adenoma. They grow slowly and don't shrink on their own. Surgery is usually recommended both to confirm the diagnosis and because untreated benign tumours can occasionally turn malignant over many years.
Do you handle cancer cases?
For head & neck oncology cases, I work as part of a multidisciplinary team — surgical management is one piece, alongside oncology, radiation oncology, and reconstruction. If you've been told you need a second opinion, that's exactly the kind of case worth bringing in.