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Management of neck lumps--a triage model
O D Smith1, P D Ellis, P W Bearcroft
1Addenbrooke's Hospital, Cambridge, UK.
Annals of the Royal College of Surgeons of England
|August 10, 2000
Summary
Out-patient triage effectively diagnosed 96% of neck lumps, including lymphomas and neoplasms. This approach enabled timely management plans for patients with neck lumps.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Diagnostic Imaging
Background:
- Neck lumps are a common presentation requiring accurate and timely diagnosis.
- Traditional diagnostic pathways may involve lengthy waiting times and multiple hospital visits.
Purpose of the Study:
- To evaluate the efficacy of an out-patient triage system for patients presenting with neck lumps.
- To assess the diagnostic yield and management implications of out-patient assessment.
Main Methods:
- A prospective review of 100 consecutive patients presenting with neck lumps.
- Out-patient assessment included history, examination, upper aerodigestive tract evaluation, ultrasound, and core needle biopsy.
- Further investigations were performed as clinically indicated.
Main Results:
- Ninety-six out of 100 (96%) neck lumps were diagnosed during the out-patient visit.
- Key diagnoses included lymphomas, parotid neoplasms, lymph node metastases, thyroglossal cysts, and branchial cysts.
- Nearly half of patients had reactive lymphadenopathy or no significant abnormality.
Conclusions:
- Out-patient triage is a highly effective strategy for diagnosing the majority of neck lumps.
- This model facilitates prompt diagnosis, enabling appropriate referrals and management planning.
- Minimally invasive procedures like core needle biopsy can establish tissue diagnosis in an out-patient setting.