ABSTRACT
The majority of surgical conditions that arise in the neck present as a swelling. Taking the history and performing the physical examination should follow the standard pattern, but there are some important features that deserve special attention. The patient should be asked about pain in the mouth, discomfort on eating, sore throats or ulceration, nasal discharge, pain or blockage of the airway, pain in the throat or neck, dysphagia, odynophagia, changes in voice and difficulty with breathing. Lumps in the neck should always be felt with the muscles initially relaxed and then with them contracted. The thyroid gland can cause two groups of symptoms and signs: those connected with the swelling in the neck, and those related to the endocrine activity of the gland. Large swellings may give the patient a tugging sensation in the neck when they swallow.
