Hello, Thanks for trusting Healthcaremagic! I have gone through your query and I can understand your concerns. Neck swelling in a thyroid patient can be due to many reasons, a detailed clinical evaluation and investigations are needed to find out the exact cause. There is no relation between yelling and the lump. The most probable differential as per your description would be a harmless self limiting condition called enlarged cervical(neck) lymph node.The presence of earpain and location of the swelling (most thyroid swellings are located at midline,lymph nodes are common on the side of neck). The lymph nodes are enlarged because of infection in the adjacent area, most probably ear infection in your case. Consult a general practitioner and do the following things done: 1.Do a detailed examination of her ear to look for any features of infection.Oral cavity examination to look for dental caries and enlarged tonsils. 2.Start a short course of antibiotics like amoxicillin fo r five to seven days. 3.Analgesics like ibuprofen or acetaminophen for pain and discomfort. 4.Do warm saline gargles and gargling with a numbing mouth wash. 5.Do a TFT(Thyroid function test) to check the status of her thyroid hormones. If the swelling persist despite all these she might need a FNAC(Fine Needle Aspiration Cytology) to confirm the diagnosis.In which a needle inserted through the lump and portion of which is taken and studied under microscope. Hope this information helps. Please feel free to contact if you have any further queries. Regards Dr Shinas Hussain