Neck mass

[TCN]

Thank you for your time.  I have a mass in the left side of my neck that lies just below the jawline, in front of the ear.  I see an ENT regularly, so when I was in to see him I pointed out the mass, and he said it was not normal.  He did an FNA, and that yielded very little.  It said the aspirate showed no malignant cells.  It is a cyst or benign tumour.  He did say that the aspirate doesn't get everything, so malignancy is slight.  But, the thoughts were branchial cleft cyst, schwonnoma tumour, or who knows.
I am scheduled for surgery on Nov 21.  My ENT, whom I have an excellent relationship.  said he wants his partner to help.  He said it is near the carotid artery and other significant nerves.  Please, if you can tell me the possibilites, and if I should not have surgery, and if I do how risky of losing nerve function.  I am extra scared as last time I had surgery with general anesthesia (heart)  I woke up during the surgery.  I could hear and feel everything, but couldn't move.  To say it was a nightmare is an understatement.  Any advice is great!

[Vivek V Gurudutt, MD]

It is tough to not be scared before surgery...especially after the experiences you have already had.  It sounds like your surgeon is being methodical in his work up.  Imaging and FNA can better characterize the lesion.  Pathology slides can be reviewed at different institutions if a second opinion on the biopsy is being considered.  Having two surgeons working together during a procedure is not uncommon.  Obviously, there are many important structures within the neck.  Your surgeon is trained to protect them.  The risks for injury to the nerves and vessels are low, but they are real and that is why he discussed them with you.  If you are concerned about having the procedure, you can always get a second opinion.  That way another set of eyes can review your history, physical, imaging, and pathology.  No recommendation is appropriate unless all of these pieces are examined.  If you have a good relationship with your ent, you should definitely discuss your fears and concerns.  Best wishes.  

[sweetpea03]

I'd get a second opinion or even third opinion before opting for surgery. And I understand the fears about surgery, I woke up during a procedure I had last year. It's not fun at all. Though I had another surgery months later and it all went great, no problems at all.

How long have you had the mass? Did it come on suddenly or gradually?

[Sugie1938]

I found a large lump just behind and below my ear last March. I hadn't noticed it before, although looking back the earring on that ear, was pushing into the back of my neck, and I couldn't figure why. It was diagonised as a Benign Licheroid Keratoses on the Parotid Gland. My doctor said it was a slow growing tumor, and because of the size 1inch across) and position, he had to schedule a long surgery, to avoid all the nerves in the face. The surgery was successful and no nerves in the face were damaged, but the nerves to the ear lobe and above was. He said I probably won't get any feeling back. That was almost 10 months ago and it is still numb, as well as the lower jaw. I am very thankful I found it when I did, and that I had a experienced surgeon, who was able to avoid nerve damage. Do a lot of research and talking to both surgeons, and have faith in them.