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A lump in the neck or neck lump is a worrying situation for any patient as they often are concerned at the possiblity of cancer. It is important to have a full history and clinical examination undertaken in relation to the neck lump. At the end of this consultation the ENT surgeon can have an idea of risk stratification as to the likelihood of this being benign such a lymph node, a thyroglossal cyst or a branchial cyst or if this is malignant representing a head and neck cancer.

It is imperative that these lumps are seen by ENT surgeons that regularly investigate them, namely with an interest in Head and Neck cancer. This will ensure that the appropriate imaging is undertaken by radiologists who are used to reading scans of the head and neck and also used to taking samples for cytology (examination of aspirates of cells from a lump).

In my clinical practice both in the NHS and privateley I am lucky to be supported by a dedicated Head and Neck radiologist and cytologist, in order to give the patient a rapid diagnosis but with a degree of certainty from clinicians who deal with this every day. It is extremely helpful to the patient with a neck lump to attend one of these rapid access Head and Neck Lump clinics as if benign the patient is reassured immediately and if malignant there is no delay in organising the appropriate investigations.

An endoscope is an integral piece of equipment required to look in the nose as part of a diagnostic or therapeutic procedure.

In sinus surgery also referred to as functional endoscopic sinus surgery (FESS) a ridgid endoscope is used by the surgeon in order to visualise the anatomy of the sinuses. The openings to the sinus system can then be directly visualised or indirectly visualised on a TV screen to allow the ENT surgeon to open the drainaige pathway of the sinuses or to open the sinus up itself.

The endoscope is a glass rod system developed to aid surgeons in keyhole surgery. The rod system is often called a Hopkins rod and has an attachment for a light source whilst also having a viewing end. The endoscope is placed in the nose and the eyepiece may be attached to the camera system to view where the endoscope is.

Endoscopes are now made with flexible fibres and are often used in the Outpatient setting to look in the nose and also to visualise the voice box.