The lymph node under the jaw is inflamed: what to do?

Causes of pathology

If the lymph node in the neck under the jaw is inflamed, then the possible causes are:

• diseases of infectious origin that affect the ENT organs and the upper parts of the respiratory system (tonsillitis, sinusitis, tonsillitis, laryngitis, pharyngitis, otitis media);
• diseases developing in the oral cavity (caries, periodontal disease, periodontitis, periostitis, or gumboil, pulpitis, gingivitis, alveolitis, stomatitis);
• systemic infections (measles, whooping cough, mumps, popularly called mumps, chicken pox);
• pathologies affecting the immune system (lymphomas, leukemia, lupus, HIV);
• neoplasms (benign or malignant) of various origins (atheromas, granulomas, lipomas, cysts);
• infections caused by parasitic microflora (lymphoreticulosis, toxoplasmosis);
• disruptions in the functioning of the immune system.

You should know that the above ailments are not always accompanied by inflammation of the lymph nodes. Quite often, the nodes remain in a normal state even if the disease is acute.

If the lymph node under the jaw is inflamed, then in 60% of cases the pathology is caused by dental problems, in 30% by diseases of the respiratory system. In 20% of cases, the reason why the lymph node under the jaw is inflamed and hurts is advanced caries, leading to the development of a purulent abscess. After tooth extraction or conservative treatment of caries, pathological processes in the lymph nodes stop.

But sometimes it is tooth extraction that can become a provoking factor and cause an enlarged lymph node. A similar situation is possible if an infection enters the hole.

Diagnostics

Therapists are involved in determining the cause of neck swelling. According to indications, patients are referred to otolaryngologists, endocrinologists, maxillofacial surgeons, and other specialists. The examination includes objective, instrumental, and laboratory techniques. The following diagnostic procedures are carried out:

• Questioning, general examination
  . A basic study that allows you to establish a preliminary diagnosis and draw up a plan for further examination. Involves studying symptoms, medical history, and assessing external changes.
• Sonography
  . Ultrasound of the neck is informative when studying the condition of organs and soft tissues, it allows you to identify tumors, areas of inflammation, determine the localization and boundaries of pathological processes. An ultrasound of the thyroid gland is prescribed if an endocrine cause of neck swelling is suspected. Ultrasound of the lymph nodes is recommended for lymphadenitis and cancerous tumors.
• Radiography
  . To exclude subluxations and vertebral fractures, X-rays of C1 or the cervical spine are prescribed. If there are symptoms of damage to the ENT organs, an x-ray of the larynx is performed.
• Other visualization techniques
  . CT and MRI of the neck are performed to detail the information obtained during sonography or radiography and make it possible to clarify the location, volume, and nature of the pathological process.
• Radioisotope scintigraphy.
  Effective in studying the thyroid gland, visualizes nodes, confirms the presence of diffuse changes.
• Endoscopic examination of the throat.
  Direct and indirect laryngoscopy, microlaryngoscopy, fibrolaryngoscopy are prescribed for lesions of the larynx. According to indications, a biopsy is performed during the study.
• Lab tests
  . Depending on the existing symptoms, general and biochemical blood tests, examination of the level of thyroid hormones and antibodies to them, microbiological analysis of swabs, punctures, blood samples, cytological or histological examination of a biopsy specimen can be performed.

Neck palpation

Stages of disease development and symptoms

Lymphadenitis in its development goes through 3 stages:

1. stage

   – the lymph nodes take on the appearance of mobile, compacted tubercles, when pressure is applied to them, pain appears, the temperature rises, sleep is disturbed, and general weakness is detected;

2. stage (purulent abscess)

   – the lymph node enlarges more and hurts even if you don’t touch it, which limits the motor activity of the jaw, pus accumulates in the lymph node, the skin around it becomes red, and the temperature is constantly elevated;

3. stage (purulent phlegmon)

   – the tumor spreads to the lymph nodes located in the armpits, the pain intensifies significantly, the skin turns blue, the temperature rises to 40⁰.

Swelling in the neck

Swelling in the neck - Growths in the neck - Lymph nodes in the neck - Lump in the neck

Patients and their families may notice a lump in the neck area, or it may be discovered during a routine examination. A lump in the neck area may be painless or painful, depending on the cause. When neck augmentation is painless, it may take a long time before patients seek medical attention.

Cause:

There are many causes of cervical mass, including inflammatory diseases, neoplasms, and congenital diseases.

The most common causes in younger patients include the following:

• local and generalized lymphadenopathy - acts as an organizational response to a viral or bacterial infection, usually of the oropharynx, tongue, salivary glands, pharynx and scalp.
• primary bacterial infection
• systemic infections
• some systemic infections (eg, mononucleosis, HIV, tuberculosis)
• congenital disorders can cause a cervical mass (a growth on the neck), usually in the long term. The most common is thyroglossal duct cyst, branchiogenic tumor, etc.
• Neoplastic masses (neoplastic masses) are more common in older patients, but can also occur in younger people. These masses may represent the site of a primary tumor or lymph node metastases from local, regional, or distant cancer. Approximately 60% of the supraclavicular mass is lymph node masses metastasized from distant primary sites. In the neck, 80% of metastatic cervical lymph nodes originate from the upper respiratory and digestive systems. Possible localization of the tumor is the lateral surface of the tongue, floor of the mouth, nasopharynx, pharynx, laryngeal epiglottis and infraorbital region.
• The thyroid gland can dilate in various disorders, such as simple non-toxic goiter, subacute thyroiditis and, less commonly, thyroid cancer.
• The submandibular salivary glands may become swollen if the salivary duct is blocked by a stone, inflammation or tumor.

Reference Information:

As a history of this disease, it should be noted how long the mass has been present, and whether it is painful. It is important to note associated symptoms, which include sore throat, upper respiratory tract infection symptoms, tooth pain, nasal congestion, ear fullness, etc.

Questions about difficulty swallowing or speaking and symptoms of chronic illness (eg, fever, weight loss, general malaise). Peripheral and distant metastases of cancer cause throat symptoms in the swallowing system (eg, cough in lung cancer, difficulty swallowing in esophageal cancer). Because many types of cancer can metastasize to the neck, a complete otolaryngological examination of all systems is important and can help find the cause of the disease.

Your doctor should tell you whether you have HIV or tuberculosis and what risk factors you may be at risk for. Risk factors for cancer include alcohol consumption or tobacco use (especially snuff or chewing tobacco), poor placement of dentures, and chronic oral thrush. Poor oral hygiene can also be dangerous.

Physical examination:

It is necessary to determine the composition of the growth on the neck (that is, whether it is soft, elastic or hard), as well as the presence and degree of sensitivity. If the mass is freely mobile or stable, it appears only under the skin or the depth must be determined.

The scalp, ears, sinuses, mouth, nasopharynx, oropharynx, hypopharynx and larynx are closely associated with possible infection and any visible damage. The base of the tongue, the base of the oral glands, the thyroid gland and the salivary glands should always be palpated for possible involvement.

The mammary gland and prostate gland are palpated for possible hypertrophy, palpation of the spleen, and examination for splenomegaly. The presence of blood in the stool indicates gastrointestinal cancer.

Other lymph nodes are palpable (eg, armpits, groin).

Attention:

The following signs are of particular concern:

• Rigid, immovable mass
• Elderly patients
• Presence of oropharyngeal lesions (other than simple pharyngitis or dental infection)
• History of chronic hoarseness or dysphagia

Interpretation of results:

Significant differentiation of factors by neck mass (including severity, pain, mobility, size and location).

A new mass (that is, swelling of the neck just a few days old), especially after symptoms of an upper respiratory tract infection or pharyngitis , signifies benign reactive lymphadenopathy .

Chronic neck swelling in young patients may suggest a congenital cyst .

A lateral cervical mass in elderly patients, especially those with risk factors, should be considered cancer until proven otherwise!

The midline mass is likely a thyroglossal duct cyst.

Pain, tenderness, or both with cervical swellings indicates inflammation (especially infection), while a painless mass is a cyst or tumor. A tough, hard, painless mass suggests cancer , while an elastic texture and mobility suggest the opposite.

Generalized lymphadenopathy and splenomegaly may be found in infectious mononucleosis . Only generalized adenopathy may indicate HIV , especially in individuals with risk factors.

Red and white mucous membrane ( erythroplakia and leukoplakia ) in the oropharynx may be a malignant change that is responsible for metastases in the neck. .

Difficulty swallowing may be noted with a thyroid tumor or cancer in various areas of the neck. Hoarseness may be due to cancer of the larynx or paresis of the recurrent laryngeal nerve.

If nasal endoscopy shows changes in the nasopharynx , then tests may include CT or MRI, and a fine needle biopsy of the lesion.

In older patients, especially those who have a risk factor for cancer, additional tests must be done first to determine the underlying cause: a biopsy of the mass may simply reveal undifferentiated squamous cell carcinoma without telling us the source of the disease. These patients should undergo direct laryngoscopy, bronchoscopy with biopsy, and esophagoscopy of all suspicious areas.

CT scan of the facial region of the skull, neck and chest is necessary. If the primary tumor is not found, a fine aspiration biopsy of the mass should be performed.

If the neck mass has been identified as a metastatic and primary tumor, then it should be considered necessary for general anesthesia - biopsy of the nasopharynx, tonsils, base of the tongue, pyriform fossa, larynx, esophagus and bronchoscopy.

Treatment:

Key points:

• A neoplasm on the neck in young patients is usually benign.
• New growths on the neck in old age usually cause cancer.
• The first and main test that guides the otolaryngologist in the right direction for diagnosis in a clinic or hospital is flexible endoscopy using a rhinolaryngoscope with or without local anesthesia. This test is painless and allows the otolaryngologist to examine the nose, nasopharynx, hypopharynx and larynx in detail using video imaging. Read more
• If you have a lump in the neck with a firm, painless, unilateral structure and a diameter of more than 2 cm, urgently consult an otolaryngologist or go to the nearest hospital for examination and diagnosis of possible malignant transformation.

Treatment methods

If the lymph node under the jaw is inflamed, how to treat it? The choice of treatment method is influenced by the cause of the pathology and its neglect. In mild cases, if the cause is eliminated, the inflammation will stop and the lymph node will return to its previous size. If complications are detected, the doctor will prescribe antibiotics or antiviral medications, painkillers, antipyretics and antihistamines. It is also necessary to take vitamins to strengthen the body's defenses. Traditional medicine will help speed up the healing process and eliminate unpleasant symptoms. The course of therapy takes a week and a half.

If a purulent infection occurs, then there will be a need for surgical intervention, during which the surgeon will open the inflamed lymph node and pump out the pus. Fortunately, this situation is extremely rare.

This article is for informational purposes only, please consult your doctor for details!

Treatment

Pre-hospital assistance

In case of traumatic injuries, the neck must be secured with a cotton-gauze collar. In other cases, it is recommended to provide functional rest to the neck and not self-medicate, since swelling occurs in many diseases that require different approaches to therapy. In case of intense pain, the use of painkillers is allowed. You should not warm your neck - this can intensify inflammatory and other pathological processes.

Conservative therapy

The conservative treatment regimen includes a protective regimen, etiopathogenetic and symptomatic drug therapy, and physical therapy. The following medications are used:

• NSAIDs
  . They are used in the form of tablets, injections, and local remedies. They have analgesic and anti-inflammatory effects.
• Antibiotics
  . Broad-spectrum medications are prescribed, and after culture results are obtained, medications are replaced taking into account the sensitivity of the pathogen. For extensive purulent processes, combinations of two drugs are recommended.
• Antithyroid drugs
  . Hyperthyroidism is considered as an indication for the use of medications. For hypothyroidism, replacement therapy is carried out.
• Antihistamines
  . Necessary for neck swelling caused by allergic reactions.

After eliminating acute phenomena, UHF, laser therapy, electrophoresis with novocaine, and anti-inflammatory drugs are used. Patients with cancer undergo chemotherapy and radiation therapy.

Surgery

For acute pain, blockades with local anesthetics are performed. Taking into account the nature of the pathology, the following operations are performed:

• Traumatic injuries
  : transoral fixation, application of a Halo-apparatus, PSO of neck wounds, tracheostomy, chordectomy, resection of the larynx, laryngopexy, removal of foreign bodies of the larynx, reconstructive interventions.
• Maxillofacial pathologies
  : parotidectomy, opening of abscesses and phlegmons of the neck, dilation of the excretory duct of the salivary gland.
• Endocrine diseases
  : enucleation of the node, subtotal resection of the thyroid gland, hemithyroidectomy.
• Otolaryngological diseases
  : removal of a median or lateral neck cyst, opening of a retropharyngeal abscess.
• Tumors
  : excision of lipomas and fibromas of the neck, removal of the thyroid gland, radioiodine therapy for thyroid cancer, laryngectomy, laryngopharyngectomy, hemilaryngectomy, installation of a voice prosthesis, Krail, Vanach operations.