What Causes Swelling in the Neck?

Swelling in the neck most commonly develops due to lymph node inflammation, viral-bacterial infections, thyroid nodules, salivary gland stones, congenital cysts, and rarely, reasons such as tumors or lymphoma. Inflammation originating from the mouth, nose, nasopharynx, tonsils, ear, larynx, vocal cords, and teeth can cause lymph nodes to enlarge. In some cases, problems stemming from the lungs or stomach can also lead to reactive enlargement in the neck. The duration, tenderness, and accompanying symptoms like fever, weight loss, or night sweats are guiding factors in the diagnosis.

What are the symptoms, and when should I see a doctor?

Painful, tender, and rapidly appearing swellings are mostly related to infections. If the swelling lasts longer than two weeks, grows rapidly, is hard or fixed, or is accompanied by unexplained fever or weight loss, an ENT specialist or related department should be consulted.

The common causes of masses found in the neck are:

Lymph node inflammation (lymphadenitis): Commonly seen after upper respiratory tract infections, dental abscesses, and skin infections; it is generally painful.

Viral and bacterial infections: Infections such as mononucleosis, cytomegalovirus, and tuberculosis can lead to persistent or generalized lymph node enlargement.

Thyroid nodules and goiter: Nodules in the thyroid gland can create a sensation of a mass in the neck; most are benign but require evaluation.

Salivary gland stones and inflammation: Can cause painful swelling in the glands in front of the ear (parotid) and under the chin (submandibular); this can increase during meals.

Cysts (branchial cyst, thyroglossal cyst): Usually noticed in childhood or young adulthood; they grow rapidly when infected.

Tumors and lymphoma: These are rare causes but must be ruled out; the swelling may be accompanied by symptoms such as difficulty swallowing or hoarseness.

How is the diagnosis made?

During the ENT examination, the nose, nasopharynx, larynx, and vocal cords are evaluated with an endoscope. If necessary, radiological imaging such as neck ultrasound, MRI, or CT is performed. Blood tests, infection markers, and advanced hematological investigations may be requested if lymphoma is suspected. If the examination and imaging are suspicious, a pathological diagnosis is made with fine-needle aspiration biopsy or excisional biopsy.

How is it treated?

Treatment is planned according to the underlying cause. For swelling in the neck originating from infection, the infection is treated first, and then the regression of the lymph nodes is monitored. Surgery may be required for benign cysts or symptomatic salivary gland stones. For thyroid nodules, follow-up or intervention is carried out in collaboration with endocrinology and ENT departments. If a tumor is detected, treatment is conducted using surgical, radiotherapy, and/or chemotherapy protocols, depending on the extent of spread. For lymphoma, a treatment protocol compliant with hematology guidelines is applied.

Can it be prevented?

Paying attention to dental and oral hygiene, treating upper respiratory tract infections without delay, and limiting smoking and alcohol are beneficial. Warm compresses at home and adequate fluid intake can be soothing; however, persistent or growing swelling in the neck must always be evaluated by a physician.