Head and Neck surgery

Question 1

Differential for midline neck lump

Answer 1

Thyroglossal cyst
Ectopic thyroid
Lymphadenopathy
Dermoid cyst

Question 2

Presentation of thyroglossal cyst

Answer 2

Midline neck lump which gets recurrently infected

Lump is attached to the base of the tongue

Question 3

Management of thyroglossal cyst

Answer 3

Surgical excision of thyroglossal cyst and middle portion of the hyoid bone to reduce risk of recurrence

Question 4

Differential for lateral neck lump

Answer 4

Cystic hygromes
Branchial cleft anomaly
Lymphadenopathy
Parotid gland abscess

Question 5

What site of dermoid cysts needs an USS

Answer 5

Bridge of nose

Need to rule out an encaphalocoele

Question 6

Management of cystic hygromes

Answer 6

USS
Preferable option is injection sclerotherapy to reduce its size
Other option is surgical excision but high risk of damage to nerves and BVs

Question 7

Most common branchial cleft anomaly

Answer 7

2nd

Question 8

Site of 2nd branchial cleft cyst

Answer 8

Anterior border of SCM

Posterior to submandibular gland

Question 9

What is a cystic hygroma

Answer 9

Fluid filled sac resulting from a lymphatic blockage
Usually seen in head and neck
Can be picked up during pregnancy