Face Lumps

Lumps on the face may simply represent skin lesions such as sebaceous cysts, but it is important to consider the possibility of tumours of the underlying structures such as salivary glands.

Diagnostics

Ultrasound

Why?

Ultrasound is an excellent way of investigating neck lumps and looking at the thyroid gland. The cause of the lump and the site it has arisen from can usually be identified.

How?

The scan is similar to pregnancy scans and is entirely painless. A gel is placed onto the skin and a doctor moves the probe across the skin while looking at the images on a monitor. On occasions the doctor may decide that a fine needle aspiration is necessary to obtain more information (see below)


CT scan

Why?

Computed tomography (CT) is a medical imaging method using X-ray tomography created by computer processing. It provides important diagnostic information in various anatomical planes. The main advantage over MRI scanning is that it demonstrates bone as well as soft tissue features. A temporal bone CT scan will therefore show details of sinus and jaw bone problems. Airway problems and head and neck cancers are well demonstrated on CT scanning.

How?

The scanning technique involves lying still with the head in a medical “hair-dryer” capsule for approximately 20 minutes. It is a completely painless procedure.


MRI scan

Why?

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to study internal soft tissue structures in detail. It provides good contrast between the different types of tissue, which is a major advantage over CT. MRI does not use ionising radiation unlike CT or traditional X-rays. Instead it uses a powerful magnetic field to align tissue atoms, and then uses radiofrequency fields to change and record their alignment. This scanned information is then used to construct images of specific parts of the body. The commonest indication for an MRI scan is parotid or tongue tumours and sinus or skull base tumours.

How?

The patient lies still on a couch with their head in a metal tube. Some patients find this enclosed experience unpleasant, which has resulted in the development of so-called “open scanners”.


Sialogram (Salivary Gland Contrast Scan)

Why?

Obstruction of a salivary duct can occur due to stones or narrowings (strictures). These may not show up on other scans. A Sialogram shows the main duct and the branching system of smaller ducts very clearly. The cause of obstruction can usually be identified. Sometimes the obstruction can be treated at the same time.

How?

A small tube is inserted into the opening of the duct in the mouth a dye is injected. X-rays are then taken. Sometimes balloons can be used to stretch open strictures or retrieve stones.

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