Head and Neck
Any neck lump or swelling that persists for more than two weeks should be referred to a specialist for careful evaluation. Common causes include enlarged lymph glands (nodes), enlarged salivary glands or an enlarged thyroid gland.
Parotid and submandibular salivary gland surgery
Swelling of one of the salivary glands is most commonly caused by a stone in the duct that carries saliva to the mouth. The swelling may come and go, typically occurring after meals. Less common causes of an enlarged salivary gland include chronic infections or tumours.
Thyroid gland surgery
A nodule in the thyroid gland may come to attention because it is noticed as a lump in the lower neck. Alternatively, it may show up as an ‘incidental’ finding on a scan of the neck performed for another reason. In most cases, the combination of an ultrasound scan and fine needle aspiration (biopsy) can confirm that a nodule is benign without the need to remove half of the thyroid gland. Removal of half or the whole thyroid gland may be recommended for ‘suspicious’ nodules or when the thyroid is enlarged to such an extent that it is interfering with swallowing or breathing.
Parathyroid gland surgery
The parathyroid glands are tiny (5mm) glands that lie close to the thyroid and are critical to the regulation of calcium levels in the body. Your GP may test your calcium levels if you have osteoporosis, kidney stones, or symptoms such as fatigue, weakness, bone or abdominal pain. Because elevated calcium levels may occur from a variety of causes, initial referral is usually to an Endocrinologist. If a parathyroid gland tumour (adenoma) is suspected, scans and referral to a specialist surgeon are indicated.
The initial signs of a throat cancer are easy to dismiss because symptoms such as sore throat, difficulty swallowing, hoarse voice and ear pain are commonly caused by simple infections. However, if symptoms persist for more than two weeks or are associated with any lump or swelling in the neck, a specialist referral is indicated. Treatment, both non-surgical and surgical, has advanced rapidly in the last decade and most patients can expect to make a full recovery.
Mr Triolo has a particular interest in working alongside surgeons from other disciplines in the management of complex cases involving the head and neck. Examples include:
- locally advanced skin cancers involving the ear, nose or lips
- parotid and lateral neck metastases from skin cancers
- tracheal or laryngeal invasion from thyroid cancer
- lateral neck or parapharyngeal metastases from thyroid cancer
- anterior cervical approaches for revision or high level (C2/3) ACDF surgery
- carotid body tumours (paragangliomas)