Referral guideline – Neck mass/swelling

Introduction

The main causes of a neck swelling in a child are reactive lymph nodes, congenital abnormalities (including thyroglossal cysts), infection (abscess), trauma (pyogenic granulomas), malignancy (including lymphoma, lymphadenopathy), and vascular abnormalities.

GP management

  • Antibiotics if lymphadenitis is suspected
  • Consider need for bloods (FBC, ELFTs, ESR, TFTs) and USS. Discuss with ENT registrar if unsure
  • Send copies of results of any investigations with your referral

When to refer

  • Swelling does not respond to a course of antibiotics
  • Hard, immobile or slow growing masses should be referred urgently
  • Note: suspected abscesses requiring drainage should be referred to the Emergency Department

Essential referral info

  • Presenting complaint and reason for referral
  • Detailed history of the swelling (onset, tenderness, movement with tongue, associated symptoms)
  • Examination findings
  • Results of any investigations performed
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/Carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Helpful referral info

  • Other past medical and surgical history
  • Antenatal and perinatal history that may be relevant – prematurity, birth weight, birth trauma, or alcohol/drug use in pregnancy
  • Family history
  • Current medications and allergies
  • Immunisations
  • Examination findings – including any dysmorphic features, full ocular examination
  • Is the patient of Aboriginal or Torres Strait Islander descent?

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111