ENT Head and Neck Surgery

Diseases of the Head & Neck

Here are some of the Head and Neck problems we see:
Photo of the report of an ultrasound of the thyroid, showing a thyroid nodule

Thyroid Nodules

Thyroid nodules are very common.  Many people have them without knowing it.  It is the invention of the ultrasound machine that makes it very easy to detect small thyroid nodules. This creates anxiety and demand for further investigations. Below is the Singapore Consensus (August 2016) on which nodules need further investigation. 

It is not necessary to investigate every nodule.  The consensus is that nodules larger than 1cm need further evaluation. Inspite of this, many of them are still turn out to be non-cancerous and do not need surgery

Singapore Consensus for evaluation of thyroid nodule

If a nodule needs further investigation, it will probably be a “Fine Needle Aspiration” for cytology where a sample is extracted via a needle and sent to the pathologist.  The report may look something like this:

Cytology Report of a Thyroid Nodule showing a Bethesda II lesion

The patient will usually be asked to return for follow-up.  Most people will return, some will not. The sample below shows the follow-up report at the next visit showing that the nodule had become suspicious

Cytology report of thyroid nodule showing a Bethesda III lesion

Most patients will keep coming back for several years.  After a while, some will figure that since nothing has happened to them so far, the nodule cannot be dangerous and they default.  Some will ask for the nodule to be removed because they are tired having to keep returning for follow-up.  Some want the nodule removed because they are retiring / changing jobs and may lose their health insurance, so they might as well have it removed before that.  

Enlarged neck lymph nodes

Cancers of the Head and Neck spread to the lymph nodes of the neck.  An ear, nose and throat examination is necessary to make sure that is no cancer.  This is easily done in the clinic in a few minutes.  


Of course, not every enlarged node contains cancer.  It could be because of an infection some where in the Head and Neck area.  Just like for thyroid nodules, an aspirate of the lymph node may produce a result show below, confirming that is is “reactive”.

Tumour of the right submandibular gland
Cytology Report of an enlarged neck lymph node

Aside from these, there are many other causes of lumps in the neck. The best way to determine the severity of it is a physical evaluation. Schedule an appointment with us and let us evaluate it for you.