Neck Masses

Abstract

Neck masses include thyroglossal duct cysts, dermoid cysts, branchial arch anomalies, and laryngoceles. The most common congenital neck mass in children is a thyroglossal duct cyst. The thyroglossal duct cysts are most commonly located below the hyoid bone. Treatment is complete excision of both the cyst and the entire thyroglossal duct up to the foramen cecum at the base of the tongue. Therefore it is necessary to remove the central portion of the hyoid bone. Dermoid cysts are usually located in the submental region in the midline. They are epithelial remnants occurring along the lines of fusion in the embryo. Branchial arch anomalies (sinuses, fistulas, cysts) result from abnormalities in the normal development of the branchial apparatus. They are present at birth but usually present in the second or third decade of life. Laryngoceles are dilations of the saccule, the lateral end of the ventricle, and are caused by increased intralaryngeal pressures. They may be classified as external or internal laryngoceles according to their relationship to the laryngeal cartilages. Cystic hygromas are anomalies of the lymph channels; 50% present by 1 year of age, and 90% by age 2. They are soft, irregular swellings. They may be located in the floor of mouth or in the lateral neck area. Hemangiomas are benign tumors that are seen in the neonatal period. Spontaneous regression may occur as the child grows.