Midline Cervical Swellings

This chapter defines the boundaries, contents, and clinical significance of the different anatomical triangles of the neck. It provides various classifications of midline neck swellings. Anatomically, midline neck swellings are classified into “superficial” and “deep” in relation to the cervical deep fascia. According to the midline anatomical regions, midline neck swellings are classified as swellings of the submental region, hyoid bone region, laryngeal/pharyngeal region, tracheal region, and supra-sternal space region. Midline neck swellings are also classified according to the tissue of origin such as lymph nodes, thyroid gland, parathyroid glands, hyoid bone, larynx, pharynx, trachea, sublingual salivary gland, blood/lymph vessels, thymus gland, and subcutaneous tissue. According to consistency, midline neck swellings are classified as “solid” or “cystic/pseudocystic.” Finally, according to age, midline neck swellings are categorized as swellings occurring in “adults” (benign–malignant) or “children” (congenital–acquired). Acquired swellings in children are further sub-classified into inflammatory or neoplastic. In this chapter, the etiology, pathology, clinical picture, diagnosis, differential diagnosis, and management of midline cervical swellings are discussed.