TVORBE GLAVE I VRATA U DJECE.

Presentation of a head and neck mass in children is very common and mostly benign. Differential diagnosis of the mass of the head and neck region in children include: inflammatory diseases (viral and bacterial lymphadenitis), lymphadenopathy (chronic inflammation, Rosai Dorfman syndrome), congenital anomalies (thyreoglossal duct cyst, anaplastic carcinoma, dermoid cysts, fistulas), vascular anomalies (lymphangioma and hemangioma), tumors (benign or malignant), diseases of the salivary glands and thyroid gland. The diagnosis of any inflammatory disease in this specific area in children is always based on thorough anamnesis of onset of the formation and clinical examination. The diagnostic protocol also includes: laboratory, microbiology, ultrasound, cytology, CT, MR and histopathology. History of the disease and clinical examination is usually followed by an ultrasound, which plays a major role in the diagnosis of thyreoglossal duct cyst, bronchial cleft cyst, lymph nodes and tumors of the head and neck. Depending on the findings of ultrasound, a FNA (Fine-Needle Aspiration) of the mass is also included. In acute inflammation (abscess) aspirate is sent for microbiological and cytological analysis. In every child with the head or neck mass, that has a rapid growth and/or a long-term lymphadenopathy, it is necessary to do an ultrasound and cytological puncture. Cytology can distinguish whether it is a case of benign or malignant tumor. If there is a presentation of a larger cyst or a vascular malformation (lymphangioma or hemangioma), depending on the localization of the mass and possible compression or other complications during the future surgical procedure, there is an indication for further radiological diagnostics, MR or CT, and for fistula MR fistulography as well. If operable, for all malignant tumors a complete extirpation is indicated with histopathological analysis, and depending on its findings, further disease staging and treatment decision is followed by a team of pediatrician, oncologist and hematologist. Treatment of acute viral inflammation should be only symptomatic. In acute bacterial infections, incision and drainage is usually necessary with parenteral antibiotic included. Treatment for cysts, fistulas and benign tumors is surgical. [ABSTRACT FROM AUTHOR]