Pediatric Head and Neck Surgery

The majority of these tumors are inflammatory in nature, but other etiologies include congenital, benign non-inflammatory, benign neoplastic, and malignant neoplastic lesions.

Congenital Lesions

A wide variety of congenital lesions may present as masses or tumors in the head and neck region. These include vascular anomalies, branchial cleft cysts (BCC), thyroglossal duct cysts (TDC), dermoid cysts, and teratomas.

Vascular Malformations

As mentioned previously, vascular malformations are evident at birth and grow commensurately with the child. The lesions may undergo a rapid change in size secondary to other influences such as infection, trauma, hormonal changes, or surgery. Capillary, venular, venous, lymphatic, and combined forms comprise the slow-flow vascular malformations.

Surgical excision is the treatment of choice for lymphatic malformations.

Fast-flow vascular malformations are considerably less common than slow-flow lesions and are comprised of arteriovenous malformation (AVM) and fistula (AVF). MRI and angiography are necessary for thorough evaluation. Symptomatic or complicated lesions may necessitate an attempt at surgical excision or selective embolization.

Benign Neoplasms

Benign neoplasms of the head and neck in the pediatric age group are relatively uncommon and are represented by a wide variety of tumors. Thyroid, salivary gland, neural, fatty, and osseous neoplasms may be encountered. Management may require surgical excision.

Malignant Neoplasms

Lymphoma: Hodgkin’s Disease and Non-Hodkin’s Lymphoma
Thyroid carcinoma is uncommon and usually presents in children older than 10 years of age. A female predominance is evident. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children.

Neuroblastoma is a malignant tumor of the sympathetic nervous system, and the precursor cells are of neural crest origin. It is the most common malignancy in children under 1 year of age, but few of these patients present with head and neck primary lesions. Nasopharyngeal carcinoma in children is rare. Salivary gland carcinoma in children is rare. The parotid is most commonly involved. Excluding vascular tumors, 50% of salivary gland tumors in children are malignant. Treatment is by excision.

Performed more than 50 surgeries in paediatric patient for benign swelling and cancer tumours which include revision surgery in more than half patients