Academy Releases New Guidelines for Evaluating Neck Masses in Adults

The American Academy of Otolaryngology–Head and Neck Surgery has released its “Clinical Practice Guideline: Evaluation of the Neck Mass in Adults” as an aid to oral health professionals and other clinicians who might be the first to encounter a patient with a neck mass. Published as a supplement in the September issue of Otolaryngology-Head and Neck Surgery, the guideline addresses appropriate testing and physical examination of an adult with a neck mass in order to promote the timely diagnosis and treatment of malignancies.

Neck masses — while common in adults due to viral or bacterial infections, oral infections, ear or sinus infections, and strep throat — can also be caused by benign or malignant tumors. Studies indicate that a patient with a neck mass may experience delays of up to three to six months from the time of initial presentation to diagnosis. “This guideline is an important instrument for the early diagnosis and treatment of potentially malignant growths, especially with the rise of human papillomavirus-related head and neck cancers,” notes M. Boyd Gillespie, MD, MSc, assistant chair for the guideline development group.

The recommendations advise clinicians against routinely prescribing antibiotic therapy for patients with neck masses unless signs and symptoms of bacterial infection are present. Providers are also encouraged to identify patients with neck masses who are at increased risk for malignancy, and either refer them for a targeted physical examination or perform the exam themselves.