Paediatric Head & Neck Surgery

Types of Head & Neck Surgery performed by Dr Florence Ngu

These are swellings that occur in the outer aspect of the eyebrow and are commonly picked up in infants before or around their first birthday. They occur because during development, the some skin cells have become trapped in the area where two areas of skin normally meet. Left alone, they will slowly grow in size and so surgical removal is recommended. The scar will be hidden in the eyebrow so that in the long term, it is barely noticeable.

After the operation, please keep the dressing dry for 48 hours. Allow the dressing to fall off by itself. The stitches are all dissolving and underneath the skin and don’t need to be removed.

This is a swelling in the midline of the neck that arises from a developmental remnant of the thyroid gland. The swelling classically moves up and down when the child swallows or pokes out their tongue. Left alone, the cyst gradually grows in size and can become infected. It may also burst through the skin and cause a fistula. An ultrasound is useful to investigate a possible thyroglossal duct cyst. The recommended treatment is surgical excision.

After the operation please keep your dressing dry for 48 hours. The dressing can be removed after a week. The stitches dissolving stitches - all underneath the skin and don’t need to be removed.

These are remnants of the embryological structures that form the head and neck. The commonest places for them to occur are in front of the ear; the midline of the neck; and the upper chest just below the collarbones. The main reason to excise skin tags is cosmesis while the main reason to excise skin pits are to prevent the risk of infection. The best age to do this is after 12 months old.

After the operation please keep your dressing dry for 48 hours. The dressing can be removed after a week. The stitches dissolving stitches - all underneath the skin and don’t need to be removed. Return to normal activity the next day but water sports in 2 weeks.

Mucoceles appear as cystic looking swellings on the lips or inside the mouth. They are caused by a blocked salivary gland. They can cause annoyance to the child especially whilst eating. They can self-resolve but if persisting after many months then surgical excision is suggested.

After the operation, your child can eat and drink as normal, although it is suggested to avoid spicy or acidic foods for 48h as they can cause a mild sting. No other special considerations are required.

The old term for this was ‘cystic hygroma’. This is an abnormal collection of lymphatic fluid, which normally circulates immune cells around the body. It can occur anywhere in the body but commonly presents as a soft lump in the child’s neck that can undergo rapid fluctuations in size, especially if it becomes infected. Ultrasound is useful in making the diagnosis. If it is small then surgical excision may be appropriate. If it is large or multi-loculated then sclerotherapy is recommended. This is a procedure where a medication is injected into the malformation under image guidance. The medication causes the lining of the malformation to scar and shrink down. The injection is performed under sedation or general anaesthetic and usually two or three sessions, 6 weeks apart, is best to minimise the risk of re-accumulation.