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Neck mass – Paediatric

Neck mass – Paediatric

This RAC is applicable to referrals for patients aged <16 years only. Please refer to the Adult ENT RAC for referrals for patients aged 16 years or more.

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Abscess or haematoma (e.g. peritonsillar, parapharyngeal (quinsy), salivary, neck or retropharyngeal abscess)
  • Acutely enlarging neck mass with any associated airway symptoms e.g. stridor, drooling, dysphagia etc
  • Airway compromise: severe stridor/drooling/ breathing difficulty/acute, sudden voice change/severe odynophagia
  • Foreign body (button batteries – inhaled or ingested), if suspicion of button battery immediate emergency review
  • Hoarseness associated with neck trauma or surgery
  • If new onset hoarse voice and any airway obstructive symptoms
  • Post-tonsillectomy haemorrhage
  • Trauma

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Nil

To contact the relevant service, please see HealthPathways: Acute Paediatric ENT Assessment

Presenting issues
  • Neck mass/lumps
Mandatory referral information (referral will be returned if this information is not included)

Investigations

  • USS neck (if likely reactive lymph node, then allow 6-8 weeks for resolution before referral)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • Thyroid function
  • FBC
  • LFT
  • CRP
  • ESR
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Neck mass that has any of the following:
    • increasing in size and/or
    • not responding to antibiotics and/or
    • persists for >6 weeks
Category 2
Appointment within 90 days
  • Suspected thyroid mass
  • All other neck masses
Category 3
Appointment within 365 days
  • No defined category 3 criteria
Last reviewed: 04-10-2023
wa.gov.au