Lymph Node Swelling Below the Earlobe: Causes and Concerns

Lymphadenopathy below the earlobe?

Doctor, I have a lymph node swelling in the right side of my neck, just below the earlobe, that feels about 1 cm in size, roughly the size of a mung bean, and has a hardness similar to the tip of my nose.
Recently, I have been experiencing persistent tinnitus in my right ear for nearly a month (a continuous cicada-like sound, occasionally with a pulsing sensation, but I can still hear clearly).
I have also noticed this swelling for about a month; I am not sure if it was there before.
During this time, the swelling has not increased in size, it is not attached to the skin, it is not painful, and when I pinch the skin in that area, I can feel that the lump is connected to the underlying muscle or tendon and can move around.
I have had an endoscopic examination of my nasopharynx, which showed no issues (I do not smoke or drink), and I underwent a hearing test at a major hospital, which was normal (with a slight high-frequency hearing loss within the normal range).
When I asked the doctor if this lump is related to my tinnitus, he examined it and said it was not related, attributing the tinnitus to stress.
On the other hand, my left ear has been extremely itchy lately, and I have been digging in it, which led to a fungal infection, and I currently have a large area of dermatitis on the left side of my cheek (but I cannot feel any swelling in the same area of the left ear).
The ENT specialist for my right ear said everything was normal, but I occasionally feel extreme itchiness in the outer ear, which I suspect may be due to a fungal infection (as I used the same ear cleaning tool repeatedly).
Is this lymph node swelling something to be concerned about?

Niu, 30~39 year old female. Ask Date: 2018/01/25

Dr. Hu Ziren reply Oncology

I recommend that you also have your left ear examined by an otolaryngologist.
Based on your description, it is possible that frequent ear cleaning has led to an inner ear infection, resulting in enlarged lymph nodes behind the ear.
It is advisable to first address the issues of tinnitus and itching, as well as the fungal infection in the ear, which are the most important concerns.

Reply Date: 2018/01/25

More Info

Lymph nodes are an essential part of the immune system, acting as filters for harmful substances and playing a crucial role in the body’s defense against infections. Swelling of lymph nodes, known as lymphadenopathy, can occur for various reasons, and understanding the potential causes and implications is vital for appropriate management.

In your case, you have described a lymph node located below the earlobe, approximately 1 cm in size, which has been present for about a month. The characteristics you mentioned—such as its size, firmness, and mobility—are important indicators. Lymph nodes can swell due to infections, inflammation, or malignancies. Given that your lymph node is movable and not fixed to the skin, it is more likely to be reactive rather than indicative of a malignancy. Reactive lymph nodes often swell in response to infections or inflammation in nearby areas.

The persistent tinnitus (ear ringing) you are experiencing could be related to several factors, including stress, ear infections, or even issues with the Eustachian tube. While your doctor suggested that the tinnitus might be stress-related, it is essential to consider that the lymph node swelling could be a response to an underlying infection or inflammation, particularly since you mentioned a recent fungal infection in your left ear. Infections in the ear or surrounding areas can lead to lymph node enlargement as the body mounts an immune response.

The fact that the lymph node has not changed in size and is not painful is reassuring. Lymph nodes that are painful and rapidly enlarging are more concerning and warrant further investigation. However, any persistent lymphadenopathy should be monitored. If the lymph node remains unchanged but you experience new symptoms, such as fever, night sweats, unexplained weight loss, or if the lymph node begins to grow, it would be prudent to seek further evaluation.

In terms of management, since you have already undergone an endoscopic examination of the nasopharynx and a hearing test, it may be beneficial to continue monitoring the lymph node. If it remains stable and you do not develop additional concerning symptoms, it may not require immediate intervention. However, if you notice any changes, or if your tinnitus worsens or new symptoms arise, follow-up with your healthcare provider is essential.

Additionally, addressing the fungal infection in your left ear is crucial, as untreated infections can lead to further complications and may contribute to systemic symptoms, including lymphadenopathy. Proper treatment of the infection may help alleviate some of the symptoms you are experiencing.

In summary, while the lymph node swelling you described does not appear to be an immediate cause for concern, it is essential to remain vigilant. Continue to monitor the lymph node and your overall health, and do not hesitate to reach out to your healthcare provider if you have any new or worsening symptoms. Regular follow-ups and open communication with your healthcare team will ensure that any potential issues are addressed promptly.

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