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What Causes Hard Lump In The Area Of Parotid Near Ear?
Question: I have a hard lump in area of masseter/parotid about an inch away from ear in between top and bottom jaw, about the size of a peanut/cashew which feels like it starts just above impacted unerrupted wisdom tooth on bottom right. It's been there for a few years and I first noticed it after having braces. For a long time now I've been finding it extermely difficult to relax my jaw. Sometimes I feel pain in the area above wisdom tooth. Sometimes I've felt feverish and earlier this year I had extreme night sweats but they've gone now. When I was having acupuncture last year, I also developed a spot on the skin over where the lump is which lasted a long time and now is small dark scar. Last year I had a MRI scan because I felt very dizzy and terrible tinnitus, which came back clear. Earlier this year, I had some neck pain on the back right side and went GP to see if the MRI had included the neck. GP said it was brain and ear canals. Does this mean it didn;t include the face and area I'm worried about? I'm so worried about this now and wondering if I should just pay for a private consultation and scan although I can't afford it.
Brief Answer:
Need a CT scan of Temperomandibular Joint
Detailed Answer:
Hi. It appears that you may have a dentigerous cyst or an impacted molar root or a parotid duct obstruction near your right TMJ (Temperomandibular Joint). Since you have described a rather long history, it sounds like multiple clinical conditions have occurred.
Your initial complaints of a hard peanut size lump sounds like a bony lesion such as a dentigerous cyst or an impacted molar that is probably out of place after the application of braces. A stone blocking the parotid duct near the upper second molar may also present similarly.
The episodes of rising pain and fever with night sweats suggest periodic infection of the cyst, molar root or parotid duct. Skin discolouration could have been due to infection or due to internal bleeding.
The dizziness and tinnitus may be an unrelated condition for which an MRI was indicated. This was probably a brain MRI to see if something was pressing on the auditory nerve to evaluate cause for tinnitus or dizziness. The MRI may not have included the jaw or neck region and an MRI is not the best investigation to evaluate bony lesions.
If I were your treating ENT specialist then I would recommend a contrast enhanced CT scan of the TMJ region to evaluate the bony hard lump - whether it is cystic or bony or tooth.
Based on the results of the CT scan an ultrasound of the right parotid region may be necessary and if the lump has fluid or tissue then a fine needle aspiration cytology (Facial) of the lump may be indicated.
I would advice you to consult your ENT specialist and discuss these recommendations. If there is active pain and fever then a course of antibiotics and anti-inflammatory medications are also indicated. If it is a bony lesion or a dentigerous cyst then a small surgical procedure may also be required.
Hope this helps. Do let me know your progress. I will be happy to advice further if you can share with me your CT scan, ultrasound or FNAC results. Hoping for your speedy recovery.
Need a CT scan of Temperomandibular Joint
Detailed Answer:
Hi. It appears that you may have a dentigerous cyst or an impacted molar root or a parotid duct obstruction near your right TMJ (Temperomandibular Joint). Since you have described a rather long history, it sounds like multiple clinical conditions have occurred.
Your initial complaints of a hard peanut size lump sounds like a bony lesion such as a dentigerous cyst or an impacted molar that is probably out of place after the application of braces. A stone blocking the parotid duct near the upper second molar may also present similarly.
The episodes of rising pain and fever with night sweats suggest periodic infection of the cyst, molar root or parotid duct. Skin discolouration could have been due to infection or due to internal bleeding.
The dizziness and tinnitus may be an unrelated condition for which an MRI was indicated. This was probably a brain MRI to see if something was pressing on the auditory nerve to evaluate cause for tinnitus or dizziness. The MRI may not have included the jaw or neck region and an MRI is not the best investigation to evaluate bony lesions.
If I were your treating ENT specialist then I would recommend a contrast enhanced CT scan of the TMJ region to evaluate the bony hard lump - whether it is cystic or bony or tooth.
Based on the results of the CT scan an ultrasound of the right parotid region may be necessary and if the lump has fluid or tissue then a fine needle aspiration cytology (Facial) of the lump may be indicated.
I would advice you to consult your ENT specialist and discuss these recommendations. If there is active pain and fever then a course of antibiotics and anti-inflammatory medications are also indicated. If it is a bony lesion or a dentigerous cyst then a small surgical procedure may also be required.
Hope this helps. Do let me know your progress. I will be happy to advice further if you can share with me your CT scan, ultrasound or FNAC results. Hoping for your speedy recovery.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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