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Thyroid / Head and Neck

THYROID LUMPS

Dr Dennis Chua is an experienced ENT Thyroid Specialist in Singapore that treats patients with thyroid nodules or thyroid diseases.

Diseases of the thyroid glands are common – It is estimated 1 in 20 patients will have a thyroid nodule that is palpable. Thyroid nodules are approximately more common in women than in men. Most thyroid nodules are benign and an accurate assessment will usually require an ultrasound scan and a needle biopsy along with a thyroid function test.

Nose & Sinus Conditions

There are several surgical approaches to remove a thyroid lump. The conventional way usually involves a skin crease incision along the anterior aspect of the neck to access the lump. This scar usually heals well if proper precautions are taken perioperatively.

Minimally Invasive Video Assisted Thyroid Surgery (MIVAT)

Dr Dennis Chua is a skilful ENT Surgeon who is able to perform this minimally invasive surgery for suitable thyroid conditions.

Several minimally invasive approaches exist to remove the lump. An example of a minimally invasive video assisted thyroid surgery is shown below.

Nose & Sinus Conditions

There are several other approaches available including robotic thyroid surgery and even transoral thyroid surgery. A thorough evaluation will be necessary to decide on the best approaches for the patient.

Personal Philosophy

Patient safety is of utmost importance and complete removal of a suspected thyroid cancer with clear margins is the priority in choosing the appropriate surgical approach. The American Thyroid Association guidelines is very useful in directing the management of patients with thyroid nodules.

Article in Business Times : 3rd December 2016

Neck Lumps

Neck lumps are common conditions encountered by ENT doctors like Dr Dennis Chua.

Lumps in the neck are common and the cause is usually benign. However, the lump may be the presentation of more serious disease, eg malignancy or chronic infection (eg tuberculous lymphadenitis) and so a thorough assessment and diagnosis are essential. If there is any doubt as to the cause, then the patient should be investigated further either with imaging or a needle biopsy. Patients over the age of 40 are more likely to have a neoplastic cause. Inflammatory, congenital and traumatic causes are more common in younger patients but neoplasm (tumors) should still be borne in mind.

Investigations that may be helpful to evaluate a neck lump:

  1. Blood tests (e.g. thyroid function test)
  2. Fine needle biopsy (e.g. thyroid, salivary, lymph nodes)
  3. Punch biopsy (e.g. tumours in the nose, mouth or throat)
  4. Lymph node biopsy
  5. X ray, CT, MRI scans or PET scans
  6. Examination under anaesthesia and biopsy (e.g. tumours behind the tongue, lower throat and larynx)

Nose & Sinus ConditionsNose & Sinus Conditions

Nose & Sinus Conditions

Lump in the oral cavity

 

Ranula

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The term ranula is derived from the Latin word rana, meaning frog, and describes a blue, translucent swelling in the floor of the mouth reminiscent of the underbelly of a frog. A ranula can sometimes present from in the oral cavity. A ranula is a type of mucocele found on the floor of the mouth. Ranulas present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland caused by local trauma.

This lady presented with a ranula that affected her speech and swallowing. She eventually underwent a transoral excision of this ranula. Care must be taken to ensure the lingual nerves (sensation to the tongue) and hypoglossal nerve (controls movement of the tongue) is not affected during surgery.

Nose & Sinus Conditions

SIALENDOSCOPY

Dr Dennis Chua is a skilful ENT Surgeon who is able to perform this minimally invasive surgery for selected salivary gland stones/calculi.

Sialoendoscopy is a minimally invasive technique that allows for salivary gland surgery to be performed in a safe and effective treatment of obstructive salivary gland disorders (eg stones) and other conditions of the salivary glands. During sialoendoscopy a small endoscope is placed into the salivary glands through the salivary ducts that empty into the mouth. Sialoendoscopy is an efficient yet simple mode of treatment for major salivary gland obstructions, strictures and sialoliths(salivary stones).

CERVICAL LYMPHADENOPATHY

Nose & Sinus ConditionsThere are around 300 lymph nodes in the head and neck region. Most cannot be felt unless they are enlarged. 95% of causes of enlargement are benign and are usually due to an upper respiratory tract infection. 5% of the time we worry about malignancy (cancer) or tuberculosis.

THYROGLOSSAL DUCT CYST

A thyroglossal duct cyst is a pocket in the front part of neck that is filled with fluid. It is formed from leftover tissue from the development of the thyroid gland during embryonic development. The thyroid gland is located in the front of the neck. This has to be investigated frequently with imaging (either ultrasound scan or CT scan) to visualise the location and to ensure it is not the only source of thyroid hormone production in the body. Also a fine needle aspiration cytology can be performed to ensure there is no malignancy.

Nose & Sinus Conditions

Nose & Sinus Conditions

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Phone: (65) 6235 3886
Fax: (65) 6235 4243

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Monday to Friday: 9:00 am – 5:00 pm
Saturday: 9:00 am – 12:00 pm

 
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