Pea sized lump in front of ear

What’s Causing My Preauricular Lymph Node to Swell?

Whenever there’s an infection, injury, or cancer, lymph nodes spring into action to fight it off. In the process, they can become enlarged.

If you have swollen lymph nodes, it’s because something is wrong. Usually, the problem is located in close proximity to the affected lymph nodes. Following are some reasons you might have swollen or painful preauricular lymph nodes.

Ear infection

An ear infection can cause lymph nodes in front of or behind the ears to swell. You might also have ear pain and fever. Ears can become infected when fluid builds up in them. This can happen when you have allergies, a sinus infection, or the common cold.

Eye infection

Parinaud oculoglandular syndrome is a type of conjunctivitis (pink eye) that can cause preauricular lymph nodes to swell. There are many things that can cause this condition, the most common one being cat scratch fever. Cat scratch fever is acquired from bacteria when a cat scratches or bites you. You can also get it when a cat licks an open wound. Other symptoms may include:

  • mucus discharge from the eyes
  • puffiness around the eyes
  • swelling of the eyelids
  • corneal ulcer
  • low grade fever and pain

Some of the less common causes of Parinaud oculoglandular syndrome are:

  • infectious mononucleosis
  • mumps
  • syphilis
  • tuberculosis
  • tularemia

Tooth infection

A tooth abscess is a buildup of pus due to a bacterial infection. Nearby lymph nodes can swell as they try to fight off this infection. Other symptoms are:

  • mouth pain
  • jaw pain
  • swollen gums
  • foul-smelling breath

Skin or scalp infection

Infections of the skin and scalp can spread to the preauricular lymph nodes. Infection of the lymph nodes (lymphadenitis) may be accompanied by fever. You might also develop an abscess, and the skin over the lymph nodes may become red and warm.

Rubella (German measles)

One symptom of rubella is that you might have swollen lymph nodes behind the neck or ears. But rubella can cause swollen lymph nodes in other parts of the body, in addition to the preauricular nodes. Some other symptoms of rubella are:

  • rash that begins on the face and spreads down
  • fever
  • headache
  • runny nose
  • painful joints

Other conditions

While swollen lymph nodes are not among the main symptoms, these other conditions can sometimes cause generalized lymphadenopathy:

  • chickenpox
  • HIV
  • Lyme disease
  • strep throat
  • tuberculosis
  • typhoid

What causes tongue bumps?

Share on PinterestCanker sores may be triggered by certain foods.

Tongue bumps have many possible causes. The mere presence of a bump on the tongue is rarely enough information on which to base a diagnosis. Some of the most common causes of tongue bumps include:

Tongue injuries

An injury to the tongue can make it look or feel bumpy. As with other areas of the body, the tongue may swell in response to an injury.

People who accidentally bite their tongues sometimes notice a swollen bump for a few days after the injury. Burns from hot liquids or foods are another common cause of tongue injuries.

Oral herpes

Herpes is a common viral infection, affecting about 60 percent of U.S. adults. Some people with oral herpes never experience symptoms. However, most people will develop cold sore blisters around their nose or mouth from time to time.

Some people also develop blisters on the tongue or gums. These blisters can be very painful and may last a week or more.

Oral herpes is contagious and can spread through saliva, direct contact with the infected area, or contact with the lining of the mouth and tongue. This can occur even when no symptoms are present.

Canker sores

Canker sores are among the most common causes of sores in the mouth. They often grow on the inside of the lips, but may also appear on the tongue. The sores tend to be red, white, or yellow in appearance and can feel raw and very painful.

Some people notice that certain foods seem to trigger canker sores. However, the cause of canker sores is still poorly understood.

Most canker sores go away on their own, but some may become very painful and necessitate a trip to the doctor.

Allergies

Food intolerances and allergic reactions may cause bumps on the tongue or make it swell. Sudden, immediate swelling of the whole tongue could be a sign of a dangerous reaction known as anaphylaxis.

A person should seek immediate medical assistance if they are:

  • experiencing swelling of the lips, mouth, or tongue
  • developing a sudden rash or hives
  • wheezing or having any other breathing difficulties

Cancer

Although rare, a bump on the tongue could be cancer. A tongue bump is more likely to be cancerous if it grows on the side of the tongue, particularly if it is hard and painless. It is worth consulting a doctor about any lump or bump that lasts longer than a week or two.

Infections

An infection in the mouth or on the tongue may cause swelling and pain at the site of the infection. If the tongue swells after being bitten or as a result of a significant injury, it is important to see a doctor.

Even a healthy mouth is full of bacteria. Any injury can make it easier for bacteria to get into the tissues of the tongue.

If the bump is very painful or comes with a fever, it is essential to see a doctor within 24 hours as this could be a sign of a serious infection.

Syphilis

Share on PinterestPeople with syphilis sometimes develop tongue sores as an early symptom of the disease.

Syphilis is a treatable but potentially life-threatening bacterial infection. People can contract the infection through direct contact with syphilis sores during vaginal, anal, or oral sex.

Some people with syphilis occasionally develop sores on the tongue as an early symptom of the disease. This is more common if the tongue is the site of infection, as is the case when syphilis spreads through oral sex.

Tuberculosis

Tuberculosis is an infectious disease that usually affects the lungs. Some people with tuberculosis develop lesions and sores on their body. The sores can be anywhere, including on the tongue.

Tongue lesions due to tuberculosis are extremely rare, but they may be the first symptom of the disorder in a newly infected person.

Oral thrush

Oral thrush is a yeast infection in the mouth. Yeast is a type of fungus that commonly grows in moist, dark places. Babies, especially newborns, often develop oral thrush.

Other risk factors for developing oral thrush include:

  • diabetes
  • corticosteroids, including asthma inhalers
  • conditions that weaken the immune system, such as HIV, organ transplantation, autoimmune diseases, and cancer
  • medications or conditions that cause dry mouth

Most people with oral thrush usually notice rough white patches on the tongue or the lips. There is often redness and a sore mouth as well.

Some people describe a cottony feeling in their mouth or a sensation of dryness. Others experience cracking near the lips, or pain when eating.

Transient lingual papillitis (lie bumps)

Share on PinterestLie bumps are tiny bumps located on the tongue’s upper surface.

Transient lingual papillitis, also known also as lie bumps, is a temporary inflammation of the tongue’s papillae. These are the tiny bumps found on the upper surface of the tongue.

Lie bumps can be painful and may cause itching, extreme sensitivity, or a burning sensation on the tongue. They usually appear suddenly. The cause of lie bumps is poorly understood, but symptoms typically go away on their own after a few days.

Irritation

Certain foods, such as sour candy or very acidic foods, can irritate the tongue, gums, and lips. This can result in hard or bumpy spots that last for a few days. If the area is sore and feels raw, recent dietary changes might be responsible.

‘What is this lump in my mouth?’

A fit and well 58-year-old woman presents to her GP with a swelling ‘underneath the tongue’ that she has noticed over the previous three months. Over the past week she has noticed some mild pain ‘on and off’ in this region but this has been unrelated to mealtimes. She denies having any foul taste in her mouth. She has no relevant medical history, has never smoked in her life and rarely drinks alcohol.

On examination, a firm, non-tender and non-fluctuant 2cm lump is palpable in the left floor of the mouth. On bimanual palpation of the floor of mouth and submandibular regions, clear saliva can be produced from both left and right duct orifices. Routine blood tests including FBC, U&E, ESR are unremarkable. The patient is referred urgently to the local oral and maxillofacial department and a diagnosis of adenoid cystic carcinoma of the sublingual gland is made.

The problem

About 80% of salivary gland lumps occur in the parotid gland, of which 75-80% are benign and most are pleomorphic adenomas (see picture on page 66). However, as a general rule to remember, the smaller the salivary gland, the more likely a neoplasm is to be malignant. It is important, therefore, to recognise that tumours of the sublingual gland, being the smallest of the major salivary glands, are more likely to be malignant than benign – approximately 60% versus 40%.

Submandibular glands, being of moderate size, are only slightly more likely to be benign than malignant. Solid minor salivary gland tumours (of the palate or upper lip for example) however, being the smallest, are malignant in the vast majority (more than 80%) of cases. Always take an upper lip lump seriously, whereas almost all lower lip lumps will be simple mucoceles.

There are numerous forms of salivary malignancy but, in the sublingual gland, adenoid cystic carcinoma is the most common, followed by muco-epidermoid carcinoma. The underlying pathology is irrelevant but what is important is the anatomical location of the swelling, which has a significant bearing on the likelihood of malignancy.

Risk factors for adenoid cystic carcinoma of the sublingual gland are uncertain and patients frequently have no history of conventional risk factors for oral malignancy, such as smoking or alcohol intake.

Features

Salivary gland malignancies are fortunately relatively uncommon and a firm lump in the substance of the floor of the mouth is more commonly due to squamous cell carcinoma (SCC). However, such tumours usually start as an ulcer, which becomes indurated and patients commonly have a history of smoking or alcohol intake – not the case in this patient. Consequently, a firm swelling in the substance of the sublingual gland without classical features of SCC is more likely to be a malignant salivary neoplasm.

Benign, non-neoplastic salivary swellings of the floor of the mouth are commoner than sublingual gland tumours and these would include a ranula (floor-of-mouth mucocele) and a salivary stone (sialolith) in the submandibular (Wharton’s) duct.

A ranula is an outpouching of salivary apparatus from the sublingual gland and may be congenital or acquired (for example, secondary to trauma, infection or surgery) in aetiology. However, a ranula is typically soft and fluctuant rather than firm. Stones in the submandibular duct are very common and these are often visible as yellowish swellings in the floor of the mouth.

Due to obstructive effects on both the sublingual and submandibular gland, the patient may experience swelling and pain in both regions, which becomes worse at mealtimes. With frank obstruction, infection often ensues and the gland becomes completely obstructed such that saliva cannot be easily milked from the duct orifice. These classical features were not apparent in this case study, making a malignant salivary neoplasm all the more likely.

Swellings of the larger major salivary glands may be malignant, but are more likely to be benign. Sinister features warranting urgent referral for a suspected malignancy would be the presence of facial nerve palsy (parotid malignancy) or hypoglossal/lingual nerve deficit (deviation, weakness or numbness of the tongue for invasive submandibular gland malignancy). However, nerve deficits are late signs. Consequently, for any progressive, hard/firm, fixed lump (especially if present for more than three weeks) or in the presence of lymphadenopathy or risk factors such as smoking and alcohol, an urgent cancer referral would be appropriate.

Benign swellings do not, in general, have the associated sinister features listed above and are typically softer and more insidious in onset.

Investigation

There is little a GP can do to investigate a suspected salivary malignancy. Routine blood tests may show signs of infection if obstructive features are present -this is the case in both benign and malignant disease. However, careful clinical examination with bimanual palpation and meticulous assessment of the rest of the head and neck for other abnormalities is key.

Diagnosis is reliant on imaging (MRI) and biopsy with fine needle aspiration cytology (FNAC) under ultrasound guidance or open biopsy under local anaesthetic if easily accessible through the oral route.

Diagnosis

Once salivary malignancy is confirmed by FNAC, local and regional staging and tumour evaluation is commonly undertaken using MRI. Ultrasound is also useful for assessing the neck with rounded nodes often being pathological, compared with normal or reactive nodes that are kidney-bean shaped. These lymph nodes can often be identified at the time of ultrasound-guided FNAC of the salivary lump itself, with FNAC done on any nodes that look worrying. As with other head and neck malignancies, CT scanning of the chest is used to assess for distant metastases.

Management

Ultimately, the treatment of choice for salivary gland malignancy is surgical excision, with or without neck dissection for regional tumour control. Adjuvant radiotherapy is commonly used after surgery to improve cure rates.

From the GP’s point of view, the history and examination, alongside recognition of benign versus malignant aetiology at different salivary gland sites is pivotal in identifying these uncommon and sometimes insidious malignancies. Urgent referral routes should be used for any patient with an unexplained lump lasting for more than three weeks, and certainly in the presence of the sinister features discussed above.

Mr Alex Goodson, Mr Arpan Tahim and Mr Karl Payne are specialty registrars in oral and maxillofacial surgery at University College Hospital, London, and

Author credit

Professor Peter Brennan is a consultant maxillofacial/head and neck surgeon at Queen Alexandra Hospital, Portsmouth

The authors have recently published a book entitled Important Oral and Maxillofacial Presentations for the Primary Care Clinician, which has been sent to every GP practice in the UK. It contains algorithms providing guidance for the management of many head and neck conditions, including neck lumps and malignant disease. The book was written in collaboration with the RCGP. Further copies are available at cost price (£12.50) from Amazon.

Resources

  1. Goodson A, Payne K, Tahim A, Brennan P. Important Oral and Maxillofacial Presentations for the Primary Care Practitioner 2016; Libri Publishing ISBN 10: 1909818933 ISBN 13: 9781909818934.
  2. Payne K, Goodson A, Tahim A, Ahmed N, Fan K. On-Call in Oral and Maxillofacial Surgery 2nd edition 2015; Libri Publishing ISBN: 9781909818583.
  3. Werning, J. Oral Cancer: Diagnosis, Management and Rehabilitation 2007; Thieme Medical Publishers ISBN: 9783131358110.
  • Infection: Occasionally, the wound may become swollen, red, tender and warm to touch (cellulitis). This is treated with antibiotics. Rarely there pus may collect under the skin (abscess), which is best treated be surgically draining the pus.
  • Blood clot: A blood clot (haematoma) may collect under the skin. This occurs in about 5% of patients and it is sometimes necessary to return to the operating theatre and remove the clot and replace the drain.
  • Salivary collection: The cut surface of the parotid gland leaks a little saliva, which may collect under the skin or drain through the skin. If the saliva collects under the skin, it can be removed with a needle. Your surgeon will recommend a bland diet for several days following surgery to minimise salivary collection.
  • Seroma: This is build up of bodily fluid occurring at the site of surgery.
  • Numbness of the face and ear: The skin of the side of the face will be numb for some weeks after the operation, and often you can expect your ear lobe to be numb permanently.
  • Numbness of the face and ear: The skin of the side of the face will be numb for some weeks after the operation, and often you can expect your ear lobe to be numb permanently.
  • Freys syndrome: Some patients find that after this surgery their cheek can become red, flushed and sweaty whilst eating. This is because the nerve supply to the parotid gland can regrow to supply the sweat glands of the overlying skin, instead of the parotid. This can usually be treated easily by the application of a roll-on antiperspirant.
  • Facial weakness: There is a very important nerve, the facial nerve, which passes right through the parotid gland. This makes the muscles of the face move and if damaged during the surgery there may be a weakness of the face (facial palsy). In most cases the nerve works normally after the surgery However, occasionally when the tumour has been very close to the nerve, a temporary weakness of the face can occur that can last a few weeks. In 1% of cases there is a permanent weakness of the face following this sort of surgery for benign tumours.
  • Tumour recurrence: occasionally the parotid tumour may recur at any time after the surgery. regardless of the diagnosis.

Salivary Gland Disease and Tumors

How is salivary gland disease treated?

Small stones might pass out of the duct without treatment. A doctor might be able to remove a stone by pressing on it if the stone is close to the opening of a duct.

Ultrasound waves can be used to shatter large stones into small pieces.

Deep or large stones are more difficult. If they cannot be removed and symptoms of pain or infection persist, the entire salivary gland may need to be removed.

Bacterial infections require taking antibiotics and extra fluid either by mouth or intravenously. Warm compresses are placed on the infected gland. Chewing sour candies encourages the flow of saliva. Surgery may be needed to drain the gland.

Antibiotics do not help cure a viral infection. The body must use its own defense system to clear itself of a virus. Bed rest, increased fluids, and acetaminophen for fever are the best ways to help the body cure itself.

Small cysts may drain without treatment. Large cysts might need surgery.

Benign tumors usually require surgical removal. Some are treated with radiation to keep them from coming back.

Malignant tumors require surgery if possible. Some tumors need surgery only; others require radiation and chemotherapy in addition to surgery. Radiation and chemotherapy are also used for tumors that are inoperable.

Prescribed medications help decrease dry mouth.

Parotidectomy

Parotidectomy is the removal of the parotid gland, the largest salivary gland. The paratoid is usually removed because of a tumor, a chronic infection or a blocked saliva gland. Most parotid gland tumors are not cancerous.

The nerve that closes the eyes, wrinkles the nose and moves the lips grows through the middle of the parotid gland. Small branches of the nerve might need to be trimmed if the gland is large and the surgeon cannot remove it. Decreased motion of facial muscles might occur while the nerve recovers from surgery. If facial movement does not completely return, rehabilitation can help restore facial movements.

Surgeons think of the gland as two separate lobes: a superficial lobe and a deep lobe. The facial nerve separates the two lobes. The parotid gland can usually be removed without permanent damage to the facial nerve. A facial nerve monitoring machine, called a facial nerve stimulator, allows the surgeons to monitor the nerve during the operation.

Benign tumors usually need only the superficial lobe removed. But if a benign tumor is deep in the gland, the deep lobe might need to be partially or completely removed.

In most cases, the entire gland is removed if the tumor is cancerous. If the tumor is small and low-grade (does not spread and does not grow quickly), the surgeon might be able to remove only the superficial lobe.

General anesthesia is required for a parotidectomy.

During the operation, the surgeon will determine the amount of tissue that should be removed. After the gland or section is taken, it is sent to a pathologist.

The pathologist slices a thin section, freezes it, colors it with special dyes, and examines it under a microscope. This procedure is called a frozen section. The frozen section is used to determine if the tumor is cancerous or benign, and the specific type of tumor. The most common type of cancer tumor in the head and neck is called squamous cell carcinoma.

After surgery

After surgery you might feel:

  • Numbness of the earlobe and incision site from the scar
  • Weak face muscles

Nerves that link to the saliva-producing areas in the parotid gland sometimes link with the nerves that control sweating in the skin. This might cause sweating of the skin at meal time (Frey’s syndrome).

A rare condition, called a salivary fistula or sialocele, can develop and cause saliva to leak through the skin.

Submandibular Sialadenectomy

A submandibular sialadenectomy is used for chronic infections, stones and tumors. Submandibular gland tumors are often malignant, in which case entire gland needs to be removed.

Many other glands in the mouth make saliva, so the mouth will still have enough saliva after the submandibular gland is removed.

Sublingual gland surgery

The incision for sublingual gland surgery is through the mouth. No incision is made in the face or neck.

Salivary Gland Cancer Symptoms and Diagnosis

There are hundreds of salivary glands scattered throughout the mouth, nose, and throat. Salivary glands are responsible for making the saliva that moistens your mouth and contains enzymes that help with digestion.

These glands are located below the surface and usually cannot be seen. Although salivary gland cancer can form in any salivary gland, about 70 percent are found in the parotid glands, located on the sides of the face in front of the ears. The two other types of major salivary glands are submandibular glands (under the chin just in front of the angle of the jaw) and sublingual glands (under the tongue).

Salivary Gland Cancer: Who Is at Risk?

Salivary gland cancers are very rare, making up only 3 to 5 percent of all head and neck cancers, meaning they occur in about one to three people per 100,000. Most patients diagnosed with salivary gland cancer are 50 to 70 years old.

Salivary Gland Cancer: What Are the Symptoms?

“The most common sign of salivary gland cancer is a lump on the side of the face in front of or just below the ear,” says Nader Sadeghi, MD, director of head and neck surgery at George Washington University in Washington, D.C. “These lumps are painless in the early stage and are firm to touch.” Here are more specifics:

  • A lump in the neck or mouth. Cancer of the sublingual glands may cause a lump in the mouth under the tongue. Submandibular gland cancer causes a lump on one side of the neck under the jaw. “A minor salivary gland mouth cancer will be a smooth bump with an unbroken surface,” says Dr. Sadeghi.
  • Pain. “Pain is usually a later symptom and indicates nerve involvement,” notes Sadeghi. In parotid gland cancer, pain may be felt in the ear. If salivary gland cancer spreads into the ear, there may be fluid draining from the ear.
  • Numbness or weakness of the face. Branches of the nerves that supply the face pass close to, and sometimes through, the salivary glands. Weakness or numbness of one side of the face can be a sign of salivary gland cancer.

Salivary Gland Cancer: How Is It Diagnosed?

Because salivary gland cancers are often visible and touchable, they can usually be found and biopsied easily. “A fine needle aspiration biopsy can often be done to diagnose salivary gland cancer. We will then do X-ray studies to make sure that the cancer is confined to the salivary gland and plan the treatment,” says Sadeghi. In a fine needle aspiration biopsy, a thin needle attached to a syringe is placed into the salivary gland and some fluid and cells are withdrawn. The cells can then be examined under a microscope.

If you notice a lump in your face or neck (even if it’s not painful) or any of the symptoms mentioned above, it’s important to get checked out by your doctor. If found early enough, surgical removal of the gland may be all that is needed to cure salivary gland cancer.

Temporomandibular Disorders (TMDs)

What Is It?

Temporomandibular disorders (TMDs) describe several problems that affect your temporomandibular joint (TMJ), or jaw joint, and the muscles of the face that help you to chew. If you place your fingers just in front of your ears and open your mouth, the movement you feel is your TMJ. It is a small ball-and-socket joint consisting of the ball, called the condyle; the socket, called the glenoid fossa; and a small, fibrous disk, which acts as a shock absorber between the ball and socket.

Studies estimate that between 20% and 30% of people experience the symptoms of TMDs. Although there is some disagreement, it appears that more women than men develop TMDs. The reason isn’t clear, but one theory is that the collagen that holds the disk in position between the ball and socket is structurally different in women. This may cause more women to have disclocated disks, which can lead to TMDs. In addition, some studies have suggested that hormones like estrogen may affect the way women perceive pain.

TMD is a general term, not a specific condition. If your dentist tells you that you have TMD, it’s a lot like your doctor telling you that you have a knee problem. Often, people will say they “have TMJ.” TMJ is the name of the joint, not a disease or condition.

The causes of TMD are not understood completely but can include:

  • Trauma to the jaw, either a direct blow to the joint or prolonged clenching or grinding of the teeth(bruxism)
  • Tension or stress, which triggers muscle spasms
  • Poor alignment of the teeth (malocclusion)
  • Arthritis of the temporomandibular joint
  • Tumors of the temporomandibular joint

Also, some general medical problems, such as rheumatoid arthritis or osteoarthritis can affect the temporomandibular joint.

Symptoms

Symptoms of TMD include:

  • Pain or tenderness in the area in front of your ear, especially when you chew, speak or open your mouth wide
  • An occasional feeling of the jaw being stuck open or closed
  • Facial-muscle spasms that make it difficult to open your mouth or that make it feel as though your teeth don’t meet normally
  • Clicking, popping or cracking sounds or a grating sensation in the jaw when you open or close your mouth
  • Headaches that tend to start in the front of the ear and spread to the rest of the head or neck

An important part of the diagnosis is reviewing the history of your problem: how long you’ve had symptoms and if they occur at certain times (such as only when eating or only at night).

Your dentist will look at the way your jaw moves, examining your teeth for signs of habits such as clenching or grinding (bruxism) and probing the TMJ and the muscles of your jaw and neck for signs of tenderness. He or she might use a stethoscope to listen for joint sounds that would suggest a disorder involving the disk or bones of the joint.

Your dentist will determine whether your problem is a muscle disorder or if it involves the bones or disk of the joint. Usually, a regular X-ray or a panoramic X-ray can rule out a serious disorder within the joint.

If a more detailed view of the joint is necessary, magnetic resonance imaging (MRI) or a computed tomography (CT) scan might be used.

The exam also will be used to check for other conditions that could be causing your symptoms, including arthritis, sinus infections, toothache, earache and neurological problems. All of these conditions have symptoms similar to those of TMDs.

When your dentist or doctor has established that you have a TMD, he or she will be able to tell you what type of TMD you have and how it can be treated.

Expected Duration

TMDs can last only for a few weeks when they are caused by trauma to the jaw, for example. Other types of TMD, such as a problem caused by arthritis or bruxism, can last months or even years, depending on how they respond to treatment.

Prevention

A TMD caused by bruxism can be prevented by using a nightguard, which is a molded piece of plastic used to reduce the pressure on the jaw. If you clench your teeth due to tension or anxiety, working with a psychologist or undergoing relaxation therapy or biofeedback may help prevent TMJ problems.

Treatment

The treatment of a TMD depends on its cause.

The treatment of a TMD depends on its cause.

Most TMDs are related to sore muscles that can spasm periodically. This type of TMD usually responds to conservative treatment, which can include any or a combination of the following:

  • Soft diet — Avoid hard or crunchy foods. Cut food into small pieces and chew with your back teeth rather than biting into large items, such as a thick sandwich, with your front teeth.
  • Physical therapy, which can include heat, massage and ultrasound
  • Intraoral plastic splints (also known as nightguards), which are similar to mouth guards, to control teeth clenching and grinding
  • A nightguard to help stop teeth clenching and grinding
  • Stress reduction therapy, including biofeedback
  • Over-the-counter pain relievers
  • Prescription anti-inflammatory medications
  • Prescription muscle-relaxing medications
  • Bite adjustment, which might include reshaping teeth slightly so that they meet properly
  • Replacement of missing teeth
  • Orthodontic therapy

If conservative measures do not provide relief, surgery might be considered. Often, surgery can be done arthroscopically, through two or three very short incisions. A tiny camera is inserted through one incision and surgical instruments are inserted through one or two other incisions. Inflamed tissue is removed and the joint is flushed.

If the jaw is locked shut because of a dislocation or scarring within the joint, open surgery might be necessary. The jaw can be repositioned and the obstructing disk can be repositioned or removed.

When To Call A Professional

Call your doctor if:

  • Your jaw movement is limited.
  • You have injured your jaw and are taking over-the-counter pain medication, but the pain doesn’t go away after several days.
  • You have swelling in the area of your TMJ.
  • Jaw pain keeps you up at night or makes eating difficult.

Prognosis

With proper care and control of habits, the symptoms should go away. Some cases may go away in less than a month. Other cases, such as those involving arthritis or people with long-standing or severe bruxism, may take longer.

Additional Info

TMJ Jaw Pain

TMJ jaw pain is a common symptom of TMJ syndrome. The jaw muscles attach to the temporo-mandibular joint by tendons which allow the jaw to move in various directions. As the inflammation of TMJ develops, it is very common for sore jaw muscles to occur. The same swelling and irritation within the jaw joint involves the muscles of the jaw as well. Therefore, sore jaw muscles are a hallmark of TMJ disorders.

In the absence of an obvious cause of jaw muscle pain, jaw muscle soreness is a fairly uncommon symptom. Some unusual arthritis conditions like polymyalgia rheumatica can cause jaw soreness, but this occurs with migrating joint pains throughout the body and sometimes a rash. Occasionally, an infection of your parotid gland (a salivary gland that lies over the jaw area) can spread into the jaw muscles and cause soreness. However, this is almost always associated with redness and swelling of the gland. Less commonly, other infections of the mouth, head and neck regions can spread into the jaw muscles and cause soreness.

In the constellation of other TMJ symptoms, though, jaw soreness is rarely from these other conditions. Ear infections, tooth infections, and trauma to the jaw area should be investigated. But in their absence, jaw muscle soreness that worsens with movement of the jaw, improves with relaxation, and is associated with other TMJ symptoms usually defines the cause of the problem. As the TMJ symptoms improve with treatment, so does the jaw muscle pain as well.

Other TMJ Symptoms:

  • TMJ Ear Pain – (Ringing in the Ear – Tinnitus)
  • TMJ Jaw Pain
  • Cheek Pain
  • Clicking Jaw
  • Lock Jaw Symptoms
  • Difficulty in Opening Mouth
  • Neck Pain and TMJ
  • TMJ Migraine
  • TMJ Headaches
  • Teeth Grinding
  • Dizziness

What causes a lump under the chin?

Many conditions can cause a lump to form beneath the chin. Accompanying symptoms and the size and shape of the lump will likely differ, depending on the cause.

Below are common causes of a lump under the chin. Some are simple, while others require medical care to prevent complications.

Swollen lymph nodes

Share on PinterestSwollen lymph nodes may cause a lump to the left or right of the chin.

Lymph nodes are located throughout the body, but a person can only feel those close to the skin’s surface, such as the nodes in the armpits or close to the chin.

Infections can often cause lymph nodes to swell. This may lead to a noticeable lump to the left or right of the chin. The swelling is a typical response of the immune system.

A lump caused by a swollen lymph node will be soft or flexible. It may be tender to touch, but it is usually not painful. The swelling should go away within 2 to 3 weeks.

The following viral or bacterial infections often cause swollen lymph nodes:

  • a cold or flu
  • ear infections
  • sinus infections
  • measles or chickenpox
  • strep throat
  • mononucleosis
  • an abscessed tooth
  • syphilis
  • Lyme disease
  • HIV or AIDS

If an infection is to blame, the lump should disappear as the infection clears up. A trip to the doctor and antibiotics may be necessary.

Benign tumors

A benign growth or tumor may cause a lump to form under the chin. Types of benign growths include cysts, fibromas, and lipomas. These are usually harmless and treatable.

Cysts. A cyst is a sac filled with fluid or debris. Cysts can form during an infection, and may slowly fill over time. Those under the jaw may be sebaceous cysts, resulting from blockages in the sebaceous glands or ducts. Damage from acne in the area can also cause cysts to form.

Fibromas. A fibroma is a round lump that can be soft or hard. They are usually found around the mouth and are not common under the chin. They usually cause no other symptoms and may signal Cowden’s disease, an inherited illness that causes benign growths to form frequently.

Lipomas. Lipomas are growths of fat cells under the skin. A lipoma lump will be soft, move easily, and have no coloration. Lipomas tend to grow very slowly, are rarely cancerous, and will usually cause no other symptoms.

Certain cancers

Share on PinterestVarious cancers may cause a lump to form under the chin, making an early diagnosis essential.

Cancers of the salivary gland, skin, or lymph nodes can cause a lump to form under the chin.

Hodgkin disease and leukemia may also lead to swollen lymph nodes.

Cancerous lumps are typically hard to the touch and may have an odd shape. There may be pain in the area if the lump is touching any nerve cells. If this continues, a person may feel partial numbness or tingling in the area.

Other symptoms of cancerous lump include:

  • a mole near the lump that changes shape or color
  • feeling a constant “lump in the throat”
  • difficulty swallowing or breathing
  • lumps in other areas near lymph nodes, such as the testicles, breasts, or armpits
  • sudden weight loss
  • a lump that keeps growing or changes shape
  • a suddenly or persistently weakened immune system
  • difficulty digesting
  • vocal changes or hoarseness
  • cysts that grow back rapidly after they are removed or drained
  • growths that discharge pus or blood

A doctor may suggest a biopsy to determine if the lump is benign or cancerous. They may recommend surgical removal.

If the lump is cancerous, doctors may also recommend radiation therapy or chemotherapy.

Treatment will vary, and a doctor will often present different options.

Other possible causes

A range of other factors can cause a lump to form under the chin. These may include:

  • a bug bite or sting, especially if the skin tends to have strong reactions
  • allergies to foods or products
  • acne
  • boils
  • salivary duct stones
  • tonsillitis
  • keloid scars
  • hematomas
  • goiters
  • medical conditions, such as rheumatoid arthritis or lupus
  • an injury, such as a cut or a broken bone
  • damage to the sebaceous glands in the chin

What’s Causing This Lump Under My Chin?

Chin lumps can be caused by the following:

Infections

Both bacterial and viral infections can cause a lump to form under the chin. Many times, these lumps are swollen lymph nodes.

Lymph nodes are part of the network of your immune system that help protect your body from illnesses. Many are located in the head and neck, including under the jaw and chin. Lymph nodes are small and flexible. They can be round or bean-shaped.

It’s common for lymph nodes in the head and neck to swell. When they do, it’s usually a sign of an underlying illness. When swollen, they can range in size from that of a pea to that of a large olive. They may feel tender or painful to the touch, or hurt when you chew or turn your head in a particular direction.

Common infections that can trigger swelling in the lymph nodes include:

  • upper respiratory infections, including colds and the flu
  • measles
  • ear infections
  • sinus infections
  • strep throat
  • an infected (abscess) tooth or any mouth infection
  • mononucleosis (mono)
  • skin infections, such as cellulitis

Many other conditions can cause lymph nodes to swell, producing a lump under the chin. These include viruses such as HIV and tuberculosis. Immune system disorders, such as lupus and rheumatoid arthritis, can also cause swollen lymph nodes.

If you have a lump under the chin caused by a swollen lymph node, you may also experience other symptoms, such as:

  • other swollen lymph nodes, such as in the groin or under the arms
  • symptoms of an upper respiratory infection, such as a cough, sore throat, or runny nose
  • chills or night sweats
  • fever
  • fatigue

Lumps under the chin caused by lymph node swelling due to an infection should go away on their own. Your doctor may suggest you monitor the swelling.

Treating the underlying infection will reduce lymph node swelling. If you have an infection, you might be prescribed antibiotic or antiviral medication. Your doctor might also suggest over-the-counter medication, such as ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol) to treat pain and inflammation. In severe cases, infected lymph nodes may need to be drained of pus.

Cancer

Cancer can also cause a lump to form under the chin. Though cancer is more likely to affect older adults, it can appear at any age.

There are a variety of ways that cancer can cause a lump to form. For instance, a lump under the chin can form when:

  • cancer is affecting a nearby organ, such as the mouth, throat, thyroid, or salivary gland
  • cancer from a distant organ metastasizes, or spreads, to the lymph nodes
  • cancer arises in the lymphatic system (lymphoma)
  • nonmelanoma skin cancer appears under the chin
  • sarcoma appears under the chin

Certain cancers can also cause the lymph nodes to swell. These include leukemia, Hodgkin’s disease, and others.

Cancerous lumps usually feel hard. They aren’t tender or painful to the touch.

Related symptoms vary according to the type of cancer. Some warning signs may include:

  • sores that don’t heal
  • changes in your bladder or bowel activity
  • lumps elsewhere in the body
  • difficulty swallowing
  • indigestion
  • unexplained discharge or bleeding
  • changes in the size, shape, and color of warts, moles, and mouth sores
  • a nagging cough
  • unexplained weight loss
  • changes in voice
  • recurring infections

When a lump under the chin is caused by a cancerous tumor, there are a number of treatments available. Your doctor might suggest chemotherapy, radiation, or surgery to remove the lump. The treatment depends on a number of factors, including your current health, the type of cancer, and its stage. Your doctor will help you understand which treatment is right for you.

Cysts and benign tumors

Other growths aren’t cancerous. These include cysts — sacs filled with fluid, or other matter — and benign (noncancerous) tumors. Benign tumors develop when cells start to divide at an abnormal rate. Unlike malignant (cancerous) tumors, they can’t invade neighboring tissues or spread to other parts of the body.

Some types of cysts and benign tumors that can cause a lump to form under the chin include:

  • epidermoid (sebaceous) cysts
  • fibromas
  • lipomas

Sebaceous cysts, lipomas, and fibromas can be either soft or firm.

Most cysts and benign tumors aren’t usually painful. They may cause discomfort, though. When a cyst or tumor grows, it can put pressure on nearby structures.

Many cysts and benign tumors don’t have related symptoms. However, if the cyst or benign tumor is close to the surface of the skin, it can become irritated, inflamed, or infected.

Other causes

A number of other health conditions can lead to the formation of a lump under the chin. These include:

  • salivary duct stones
  • acne
  • food allergies
  • goiters
  • an injury
  • hematoma
  • insect stings or bites
  • broken bones
  • a fractured jaw
  • certain medications

In these cases, symptoms and treatment depend on the source of the lump.

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