Head & Neck
Diseases of Head & Neck
Head and Neck comprise of the central nervous system and the other main sense organs such as Eyes, Nose, Ears, and Tongue. The formation of CNS starts from the 3rd week of pregnancy within the womb. The CNS consists of the brain and the spinal cord. The Brain is the master of the human body. It is an organ and acts as a center of the nervous system in all the Vertebrates. It regulates and controls each and every system in the body.
The diseases of the Head and Neck comprises the diseases of Brain, Ears, Throat, and all the glands involved in it. More than 20% of people in India suffer from Head and Neck diseases every year. the most common head and neck diseases are throat cancer, bell’s palsy, cleft lip and cleft palate, thyroid gland disorders, tuberculosis, and so on.
There are a variety of causes affecting the person are age, hereditary, genetic, regular and chronic habits, environmental, socioeconomic and immunological factors but it is also proved that stress also plays a vital role in the disease like thyroid gland disorders. The most common causes of oral cancer found in India, is due to the chronic habits of smoking and tobacco or betel nut chewing. Symptoms include difficulty in swallowing, non-healing ulcers and restricted mouth opening. The fatal rates are high if not diagnosed and treated early.
Head and Neck diseases can also be categorized according to its origin like inflammatory diseases, autoimmune diseases or may be granulomatosis diseases. Some growths are not localized to Head and Neck region but also spreads or involve the other following tissues or organs. There are also many infections present in the environment leading to other diseases such as Pharyngitis, Tonsillitis, Otitis media, Oral candidiasis, Rhinitis etc which are due to the viral and the bacterial infections.
Head & Neck Cancer
It is the Metastasis of the cancer cells into the tissues commonly involving mouth, nasopharynx, throat, trachea, larynx and pharynx.
Causes of head and neck cancer It Includes chronic and heavy alcohol consumption, gutka chewing, tobacco and betel nut chewing. Other causes may be Gastroesophageal reflux disease [GERD], radiation exposure, Human papilloma virus, Epstein-Barr virus, increased intake of red meat, poor nutrition and vitamin deficiency.
Symptoms of head and neck cancer Usually depends on the parts affected. Hoarseness of voice, non-healing ulcers in the oral cavity for more than a period of 6 months, enlarged lymph nodes, unexplained weight loss, difficulty in food swallowing, bleeding of the parts involved, mass or nodular swelling in the affected parts.
Diagnosis It can be made by a thorough clinical history and physical examination. Biopsy of the lesion can also help in confirmation
Treatment for head and neck cancer The treatment depends on the part, degree and stages of infection.Radiotherapy, chemotherapy and in some cases surgical excision is done to treat the cancer.
Hydrocephalus
It is a condition in which there is an excessive and abnormal accumulation of the Cerebrospinal fluid within the brain. It is most commonly seen in infants and children.
Causes of hydrocephalusr Congenital - There may be an infection of the fetus during pregnancy with diseases like Rubella and Cytomegalovirus. Acquired - Due to Bacterial Meningitis, Posterior fossa tumors, Arteriovenous malformations.
Symptoms of hydrocephalus In congenital there may be difficulty in the normal labor due to the large size of the head. This may lead to injury with bleeding, tumors or infections of the head. Other symptoms include irritability, headache, personality behavioral changes, nausea, vomiting and drowsiness.
Diagnosis CT scans, Pneumoencephalography and MRI scans are helpful. Treatment for hydrocephalus It may be self-limiting if not then Ventricular shunts are available to drain the fluid to avoid irreparable damage.
Migraine
It is a benign primary headache disorder usually characterized by frequent headaches in moderate to severe forms.
Causes of a migraine It includes genetic and hormonal causes, gastric problems,hunger, alcohol, physical exercise, glare, sunlight, tension and stress or by any other chemical stimulant.
Symptoms of the migraine include 4 phases
1. Prodrome phase - where there are altered mood and behavior, muscular stiffness and sensitivity.
2. Aura phase - It lasts from a few minutes to less than 1 hour. There is blurred vision with disturbances in
reading and walking.
3. Pain phase - Moderate to severe pain, one sided throbbing type of headache, sensitivity to sounds and
light, nausea, vomiting. Attacks are usually 4-72 hours and are frequent and repeated in nature.
4. Postdrome phase - which includes weakness and depression of the person.
Diagnosis It is generally diagnosed through clinical history and symptoms. Neuroimaging also helps in the evaluating the case.
Treatment for a migraine It includes mild analgesics to other specific medicines for the Migraine.
Angiomatosis
It is usually a non- cancerous growth with little knots of capillaries in various organs. It is due to the multiplication of the cells forming a tumor in any part of the body. They are sponge-like with large dilated spaces. It is commonly associated with Von Hippel - Lindan disease
Symptoms of angiomatosis Symptoms of angiomatosis usually depend on the organs involved. But common symptoms are a headache, dizziness, weakness of limbs, an imbalance in walking, vision problem, high blood pressure and other heart related disorders. Prognosis depends on the size and location of the tumor. There are cases of death if associated with Kidney and Brain.
Diagnosis CT and MRI scans help in the location and size of the tumor thereby helping diagnosis and further treatment.
Treatment for angiomatosis It depends on the organ involved. Mainly Surgical excision of the tumor by a specialist doctor is done.
Neck Pain
It usually arises from the diseases of the cervical spine and soft tissues of the neck which gets triggered by the movements of the neck.
Causes of neck pain It includes Injury to the cervical spine due to the fractures or accidents, or spinal compression. Cervical disc diseases, Cervical spondylosis, Osteoarthritis, Rheumatoid arthritis, abscess or swelling in the neck region, metabolic bone disorders are more common causes.
Symptoms It includes pain, swelling, tenderness of the parts, neck stiffness, immobility of the neck, pain may be localized or may radiate to the involved arms, hands and fingers.
Treatment for neck pain In cases of injury the pain is self-limiting but other causes to be treated specifically. Physiotherapy and neck muscle strengthening exercises can help to some extent.A Soft cervical collar is advised in severe pains and immobility.
Squamous cell carcinoma
It is the most common type of cancer in the Head and Neck region. It mostly occurs in the oral cavity, neck, tongue, floor of the mouth and gums. It is the most rapidly growing cancer which is asymptomatic.
Causes of squamous cell carcinoma Chronic habits like gutka chewing, betel nut chewing, tobacco consumption and cigarette smoking. Other causes include radiation exposure, burns or scar, UV exposure.
Symptoms of squamous cell carcinoma It appears as the ulceration of the surface cells and base of the lesion is indurated on examination. In the oral cavity there may be white and scaly patches, bad breath, burning sensation, difficulty food eating and swallowing and difficulty in speech.
Treatment for squamous cell carcinoma It is treated by localized radiotherapy and chemotherapy. It can be prevented by following healthy habits.
Cyst
A Cyst is a closed cavity which has its own outer membrane and is differentiated by the nearby tissue. It is a group of cells forming together into a cyst. It may be filled by air, fluids or semi-solid material. Some cysts also can become cancerous by rapid multiplication forming a tumor. A Cyst can occur in any part of the body. The common Head and Neck cysts are sebaceous cyst and Pilar cyst which occurs on the scalp, Arachanoid cyst in the arachanoid membrane of brain, Choronoid plexus cyst and colloid cyst in the brain, Dentigeous cyst within the oral cavity.
Causes of cyst Causes of cyst are usually unknown, but injury or trauma within the organs or membranes may be the probable cause.
Symptoms of cyst Symptoms of cyst depend on the location and size of the cyst. It is usually painless but may be associated with the organ related symptoms.
Diagnosis Usually noticed when the patient has to present complaints pertaining to an organ or region, X-Ray, CT and MRI scans helps in revealing the existence of the cyst.
Treatment Local surgical excision can be done. If it is a cancerous cyst, then along with excision, chemotherapy and radiotherapy are to be followed.
Spasm
Spasm is the involuntary contraction of the single muscle or a group of muscles. It may lead to the tear in muscles, tendons or ligaments depending on the force of the contraction. Tetanus and Epilepsy are the two common diseases of Head and Neck region.
Tetanus Caused by the bacterium ‘Clostridium tetani’. It is usually seen in rust or rusty nails. The Body gets infected by the break in the skin during cut or puncture.
Symptoms include Lock jaw, difficulty in opening mouth and difficulty in swallowing food. Spasms begin from the jaw and then progress to rest of the body. Spasms may last for a few minutes. It may lead to headache, increased blood pressure, increased heart rate, fever and fracture of bones.
Prevention is done by Tetanus toxin vaccine soon after an injury and during pregnancy it is advisable to vaccinate to prevent the fetus from being infected.
Oropharyngeal cancer
When there is a metastasis of the cancer cells in the oral cavity including the pharyngeal walls, base of the tongue, tonsils, soft palate it give rise to Oropharyngeal cancer.
Causes of oropharyngeal cancer - Human Papilloma virus, chronic habits of gutka chewing, betel nut chewing, alcohol consumption, tobacco consumption in any forms, poor nutrition, and socioeconomic causes.
Symptoms of oropharyngeal cancer It includes pain, swelling, difficulty in opening the mouth due to ulcers and lesions, difficulty in swallowing, burning and redness of ulcers, erosive and bleeding ulcers which are non-healing, and difficulty in speech. It may be localized or affect the secondary and nearby organs.
Diagnosis It is diagnosed by taking a Biopsy and Clinical examination of the non-healing ulcers.
Treatment for oropharyngeal cancer Involves the elimination of the risk factors and correction in the diet. Radiotherapy and chemotherapy depends on the stages and lesions involved.
Neck stiffness
It is the rigidity of the neck muscles where the patient experience discomfort or pain in the movement of the neck and shoulders.
Causes of neck stiffness acute cause may be due to the wrong position during sleep, muscle sprain or strain due to heavy weight lifting or due to muscular spasm. And other causes may include injury to the cervical disc either by compression of the nerves or by herniation of the cervical disc. Meningitis may be one of the most important causative factor.
Symptoms of neck stiffness Pain in the region of the neck, tenderness, restricted movements of the neck and shoulders.
Treatment for neck stiffness Doctors usually follow the conservative line of treatment like mild hot sponge bath or physiotherapy or exercise to strengthen the muscles of the neck and arms. Other causative factors may follow specific treatment.
Whiplash
It is also called as neck muscle strain. Whiplash is due to the trauma or injury to the muscles and ligaments by over rotatory movements of the arms. It is differentiated from the muscle sprain, sprain leads to the tearing of muscles. It is mostly seen in athletes and sports persons.
Causes of whiplash Causes of whiplash are due to an injury or trauma and also due to overuse of muscles of the arm.
Symptoms of whiplash Pain of the affected muscles, restricted movements, stiffness of the muscles, difficulty movements of the limbs, tenderness of the muscle and headache at the base of the neck.
Diagnosis CT scans, X-Rays and history of injury gives the diagnosis.
Treatment for whiplash It is generally treated by the Cold application on the affected parts followed by the heat fomentation. Analgesics to reduce the pain and Neck braces and collars for immobility from preventing further damage. Physiotherapy can also be advised.
Pustule
A Pustule is a small eruption on the skin with infected pus inside. Pus may be white or yellow in color. It is due to the death of the inflammatory cells. It may be present in any part of the body or organ including the oral cavity and nasal cavity.
Causes of pustule Causes of a pustule are viral infections like herpes zoster, herpes simplex, acne or boil or abscess or any other inflammation of the skin or tissue giving rise to a pustule. Blood dyspraxia may also lead to pustule formation.
Symptoms of pustule Include stinging and burning pain in the region, tenderness, swelling and obstructive sensation.
Treatment for pustule - It includes correction of the diseases involved. Antibiotics and analgesics to relieve the pain are advised.
Torticollis
Torticollis is also called as WRY NECK. In this medical condition there is a fixed movement of the neck.
Causes of torticollis Causes of torticollis may be congenital and acquired. Congenital includes injury during birth, hard mass on neck at birth. Acquired causes are diseases like cervical vertebrate diseases, tonsillitis, adenitis, rheumatism, enlarged cervical glands and abscess in the larynx or pharynx.
Symptoms of torticollis The most common symptoms of torticollis are neck pain, tenderness of the cervical spine. Movements may be to one side, forward bending,and backward bending or may be combination of two movements. In case of congenital torticollis, it is diagnosed by the USG of the neck and color histogram after 1-4 weeks of birth. The conservative line of treatment such as physiotherapy and exercise are preferred in self-limiting disorders. Surgery is performed after 1 year of birth in congenital cases.
Paresthesia
This medical condition is defined as the perverted sensibility or the abnormal sensation without any physical or external cause. Examples include tingling, pricking, numbness and crawling of bugs or ants. In Greek language Para means abnormal and aesthesia means sensation.
Symptoms of paresthesia Symptoms of paresthesia are transient and chronic. Transient symptoms involves in the hands, feet, legs and arms. These are electric shock like symptoms. There may be panic attacks, short breaths, cold sore, pain and tingling sensation.
Chronic symptoms of paresthesia Chronic symptoms of paresthesia include the problem with the functioning of the neurons and poor circulation. It is due to vitamin deficiency or metabolic disorders like Diabetes mellitus, Hypothyroidism, Hyperparathyroidism, Carpal tunnel syndrome, Rheumatoid arthritis. Treatment for paresthesia depends on the condition of the patient and the removal of the cause.
Occipital neuralgia
Occipital neuralgia is also called as Arnold’s Neuralgia, where there is chronic pain in the upper and back of the neck and behind the ears.
Causes of occipital neuralgia Causes of occipital neuralgia are tension headache, migraine, and glared vision, damage to the occipital nerves by pressure or compression or contraction due to injury to the neck.
Symptoms of occipital neuralgia Most characteristic symptoms are the aching, sharp, shooting, zapping and throbbing pains. They are frequent in nature. Other symptoms include chronic attacks of headache, pain in the back, one sided headache, blurred vision,and difficulty in speech, pain in the eyebrows and behind the eyes.
Treatment for occipital neuralgia The symptoms will reduce through heat, rest and physical therapy. Surgical intervention is followed when conservative methods fail.