Prevalence and Aetiology of Neck Masses among Patients Receiving Surgical Services at Muhimbili National Hospital

Abstract

Background: Neck masses are found in all age groups from many causes, ranging from congenital to acquired pathology. They can become a diagnostic challenge due to some of conditions that have this signal as the main manifestation. The prevalence of the neck masses at M.N.H is not yet known despite attending several patients presenting with neck masses. We also have late referral and management of patients with neck masses, and this can be due to lack of knowledge on neck masses. Objective: The study aimed at determining the prevalence and aetiology of neck masses among patients receiving surgical services at Muhimbili National Hospital in Tanzania. Methods: Descriptive hospital based cross sectional study was done from July to December 2016 involving the patients who were admitted in Otorhinolaryngology, Oral Maxillofacilal Surgery, General Surgery and Pediatric surgery wards. The participants who met the inclusion criteria were interviewed and thorough clinical examination was done. For the study participants with neck masses FNAC of the neck masses was done or open biopsy for ulcerated masses. Primary site of malignant neck masses was determined through various methods including indirect laryngoscopy, direct laryngoscopy and OGD then results were filled in questionnaires. CHI square test was used to test for significance. Statistical Package of Social Sciences (SPSS 20) computer software was used to analyze the data and a P-value of less than 0.05 was considered as statistically significant. Results: The overall prevalence of neck masses was found to be 14.1% and proportion of neck masses was found to increase as the age increased. The prevalence of neck masses did not differ significantly between males and females. Anterior triangle was the most anatomical site in the neck with neck masses (53.8%). Most of the neck masses (65.7%) were malignant and the age group most involved was >60 years (P-value 0.000). SCC was the leading malignant subtype among the malignant neck masses (54.1%). It was also found that 67.21% of the malignant neck masses were the metastatic nodes from primary cancers in the upper aerodigestive tract. Conclusion: This study shows that neck masses are prevalent at MNH and proportion of neck masses increase as the age increase. The most anatomical site involved with the neck masses was anterior triangle. Most of the neck masses were malignant in which majority of them were metastatic nodes from upper aerodigestive tract. Any neck mass especially in adults need thorough evaluation including upper aerodigestive examination to rule out possibility of malignancy. Key words; neck masses, prevalence