The enlarged lymph nodes become palpable in children very often. They are generally associated with an infection of adjacent tissue and will return to their normal size in a couple of weeks. They must be evaluated by a pediatric surgeon when they persist beyond the adjacent infection (more than 4 weeks), do not respond to antibiotic treatment, are abscessed (cervical abscess), have rapid growth, are at the supraclavicular or posterior cervical level, or exist the suspicion of a cancer.
Branchial Cysts and Fistulas
They are malformations due to the lack of closure or reabsorption of the clefts and / or branchial arches that allow the formation of neck structures during fetal development. They can present as cartilaginous remnants, cysts, fistulas, or sinuses, usually in the lateral portion of the neck. They can complicate with an infection and require antibiotic and anti-inflammatory treatment. It should be resected at diagnosis or after the infection has been controlled.
The thyroglossal cyst is a congenital defect due to the persistence of the duct that allows the thyroid gland to descend from the base of the tongue to the neck during fetal development. Its clinical presentation is of an anterior cervical mass, with redness and pain if infected. Although it is a congenital defect, it can occur after birth even in adulthood, due to fluid accumulation in the cyst or infection. Ideally it should be resected at diagnosis before it becomes infected.
Lymphatic Malformation or Lymphangioma
Cervical lymph nodes
Lymphatic Malformation, Lymphangioma, or Cystic Hygroma
Adenoflegmon or Cervical Abscesses
Inflammation of axillary nodes by BCG vaccine in an infant
Malformations of the lymphatic vessels are present from birth and look like a mass at birth or can become evident when they accumulate fluid, infection or bleeding. They can be located all over the body but the cervical mass is frequent presentation. It is made up of multiple cysts with liquid inside (lympha). Large cyst lesions have a better response to treatment.
Median Cervical Fissure
It is a rare malformation, which generally presents as a single malformation. Requires surgery to allow better neck mobility.
Adenophlegmon or Cervical Abscess
Abscesses are a collection of pus in the center with a wall of inflamed tissue around it. Cervical abscesses can be due to multiple causes. The most common is bacterial infection of cervical lymphadenopathy, but it can also be due to a dental infection, a lymphatic malformation, branchial remnants, or an infected thyroglossal cyst. You need surgery and antibiotic treatment. The most appropriate treatment will depend on the cause of the abscess.
Inflammation of the Arm or armpit by BCG vaccine
The BCG vaccine installed in all children in Chile in the first days of life, can cause inflammation in the area of the arm where the baby was vaccinated, or swollen glands in the armpit or neck. This is known as BCGitis or Becegeitis and occurs between the first weeks of life up to 24 months. In general, management is observation, but may require drainage depending on the characteristics. abscess.
Fibrosis and intense contraction of the sternocleidomastoid muscle produces rotation of the head, difficulty in achieving complete and normal neck movements. If left untreated, facial asymmetry and cranial deformities may develop. Treatment consists of kinetic exercises in children under the first year of life and in case of lack of treatment at that age, surgical treatment is suggested. In older children, there are several treatment options focused on partially or completely sectioning the compromised muscle, associated with treatment by a kinesiologist.
They are redundant cervical folds found in girls with Turner Syndrome. It can produce alteration of cervical mobility and they are operated to decrease the stigma of this syndrome and improve mobility.