Neck Masses: When to Consult an ENT Specialist

Neck mass

Hello Doctor: I am a patient with type 2 diabetes.
Last week, I discovered a lump on the right side of my neck near the earlobe that is not painful, and I have no symptoms of a cold.
The week before I found the lump, I had a minor outpatient surgery.
When I returned for suture removal, I asked the doctor about it, and he said there was no inflammation or infection at the surgical site.
However, I noticed a lump near my earlobe.
He suggested that I see an otolaryngologist.
I looked up "lymphadenopathy" and "parotitis," which typically present with redness, swelling, heat, and pain, but I do not have any pain—just a hard lump there.
I have already visited a doctor who asked a lot of questions, such as whether I smoke or drink alcohol, how much water I drink, and if I have had any cold symptoms.
They also performed a nasal and oral endoscopy and prescribed antibiotics.
I have an ultrasound scheduled for the 15th.
After taking the antibiotics for a few days, I noticed that the lump has decreased somewhat, but I can still feel a distinct hard mass there, although it is not as swollen as before.
What else could it possibly be? If the lump has resolved by the time of my scheduled examination, do I still need to go for the check-up?

Ling Er, 20~29 year old female. Ask Date: 2022/07/07

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the inflammation or swelling may be due to lymph nodes or salivary glands, tumors, cysts, etc.
It is advisable to consult an otolaryngologist for further examination if symptoms persist.

Reply Date: 2022/07/07

More Info

When it comes to understanding neck masses, particularly in the context of your recent experience with a lump near your ear, it's essential to approach the situation with a clear understanding of potential causes and the appropriate steps to take. Given your background as a type 2 diabetes patient, it’s crucial to monitor any changes in your health closely, as diabetes can sometimes complicate healing and immune responses.

The lump you described could be a variety of things, including a swollen lymph node, a cyst, or even a benign tumor. The fact that it is hard and non-painful is noteworthy. Lymph nodes can swell due to infections, but since you mentioned that there are no signs of infection and the lump has decreased in size after taking antibiotics, it may not be an infectious process. However, the persistence of the lump, even if it has reduced, warrants further investigation.

In general, you should consult an ENT (Ear, Nose, and Throat) specialist if you notice any of the following:
1. Persistent Lump: If the lump does not resolve completely after a reasonable period, or if it continues to change in size or shape, it is advisable to seek further evaluation.

2. Associated Symptoms: If you start experiencing additional symptoms such as difficulty swallowing, changes in your voice, unexplained weight loss, or persistent pain, these could indicate a more serious condition that needs immediate attention.

3. Duration: If the lump has been present for more than two weeks without improvement, it is wise to consult a specialist.
4. Underlying Conditions: Given your diabetes, any new or unusual symptoms should be evaluated promptly, as diabetes can affect your immune system and healing processes.

Regarding your question about whether you still need to go for the ultrasound if the lump has disappeared by the time of your appointment, it is generally advisable to keep the appointment. The ultrasound can provide valuable information about the nature of the lump, even if it has resolved. It can help rule out any underlying issues that may not be immediately apparent through physical examination alone.
In summary, while the initial signs may suggest a benign process, the persistence of the lump, even after treatment, indicates that further evaluation is warranted. Consulting an ENT specialist will provide you with a comprehensive assessment and peace of mind. They may perform imaging studies, such as an ultrasound or CT scan, and possibly a biopsy if necessary, to ensure an accurate diagnosis.
In the meantime, continue to monitor the lump and any other symptoms you may experience. Keeping a record of any changes can be helpful during your consultation. Remember, early detection and intervention are key in managing any health concerns effectively, especially with your diabetes history.

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