Lateral Cervical Swellings

This chapter describes the boundaries, contents, and clinical significance of the anterior and posterior cervical triangles. The neck also contains such triangles as the sub-occipital triangle, the triangle of the vertebral artery and scalene triangle, as well as Lesser’s, Pirogov’s, Béclard’s, and Farabeuf’s triangles. Mastery of such anatomical detail is an essential requisite to safety and precision in all neck operations thereby minimizing damage to the many structures contained in such a small area. Lateral cervical swellings are classified as congenital versus acquired, solid versus cystic, or according to the anatomical sub-region of presentation. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. The aim of this chapter is to provide the clinician with a systematic approach to a patient with any lateral neck mass and a guide to appropriate investigations so that the proper diagnosis and treatment could be made. The proposed clinical approach involves an understanding of the anatomy of the lymph nodes and major structures of the neck and the possible pathology that may arise in such structures. If one can first identify the structure that is enlarged causing the mass and second match that with the pathologies that may occur within that structure, then most of the challenge is solved, and appropriate investigations and adequate treatment can be performed.