Sunday 27th November - Neck Lump

Mr Richard Adamson is a Consultant ENT Surgeon at Spire Edinburgh Hospitals.

While the majority of neck lumps are nothing to worry about, many are an indication of a more serious problem.

Current guidelines recommend that any neck lump present for more than three weeks should be  referred to a specialist in head and neck problems. This will usually be an ear, nose and throat (ENT) surgeon with a specific interest in head and neck cancers.

To make a diagnosis, your surgeon will undertake a thorough examination, including an endoscopic examination of your throat and a biopsy. This is often taken with a needle similar to a blood test. Further investigation will usually include an ultrasound or CT scan.

This should provide enough information to hopefullybe confident that your neck lump is nothing to be concerned about and be left alone, but obviously if there is any concern will lead on to further investigations.

Sunday 20th November - Grommet

Mr Alex Bennett is a Consultant ENT Surgeon at Spire Murrayfield Hospital.

A grommet is a tiny tube which is inserted through the ear drum to enable middle ear ventilation.

There is a connection between the back of the nose and the middle ear known as the Eustation tube which prevents negative pressure and fluid accumulation behind the ear drum. In children the Eustation tube is more likely to malfunction because it is shorter and floppier. As a result children more commonly develop fluid behind the ear drum, known as glue ear, which can result in deafness and recurrent infections. In most children this is only temporary, however, those with persistent symptoms may benefit from grommets.

Inserting grommets is a simple procedure which takes about 15 minutes. It is usually performed as a day-case under a general anaesthetic. The grommets usually come out by themselves after six to 18 months, by which time the symptoms have resolved.

Sunday 13th November - Dupuytren’s Disease

Mr Chris Oliver is a Consultant Orthopaedic Hand Surgeon at Spire Shawfair Park Hospital.

Dupuytren’s Disease, a connective tissue disorder producing thick cord-like bands in the palm of the hand, is common and traditionally treated with surgery. A non-surgical treatment for Dupuytren’s is now available as a collagenase enzyme injection directly into the band in the hand, this acts to dissolve the contracted tissue. The Dupuytren’s tissue will still remain in the hand long-term but the finger will be straighter. Once the diagnosis is confirmed the affected digit is injected and then a day or so later the patient comes back to the clinic to have the digit manipulated. A hand dressing is then applied.

Early clinical results suggest the enzyme injection performs as well as the traditional fasciectomy surgery in which the band is carved out of the hand. Complications of the non-surgical treatment can be minor skin tears and stiffness, but are not often seen. Dupuytren’s can still recur after injection, but the procedure carries less risk than surgery, which may cause nerve damage and has longer recovery times.

This injection treatment can be used where previous surgery has failed and this non-surgical treatment allows rapid return to better function.

Non-surgical treatment for Dupuytren’s is now available at Spire Murrayfield Hospital, and Shawfair Park Hospital, Edinburgh, in the Hand Surgery Clinic.

Sunday 6th November - Ankle Pain

This pain could be an Achilles tendinopathy.  Symptoms will usually include pain and stiffness in the tendon particularly in the morning or after rest and there may be a lump about 2-4cm above the heel.   Achilles tendinopathy is an overuse injury and is common in sports that involve running and jumping, but other factors such as a change in footwear or training surfaces, weak or tight calf muscles or abnormal biomechanics can  contributed to the problem.

It is important to seek the advice of a Chartered Physiotherapist with regard to appropriate stretching and strengthening exercises and it may be that you can continue to run as long as there is minimal pain which clears within 24 hours of running.   Your GP can give advice regarding any suitable medications which may help.  It is important to ensure your footwear is appropriate and well fitting for your sport and biomechanical issues can be addressed following an assessment fro a podiatrist.  In some situations a consultant referral may be appropriate to more persistent pain and a Corticosteroid injection into the tissues surrounding the tendon may be advocated. 

For further information contact Spire Edinburgh Hospitals Physiotherapy department on 0131 316 2537 or 01506 448181.