The Thyroid Head and Neck Surgery Centre, headed by Thyroid Surgeon Dr Ranjiv

Sivanandan is a one-stop facility that provides you with a comprehensive evaluation of:

• Thyroid nodules
• Parotid and salivary gland tumors
• Tongue, mouth, and throat ulcers or growths
• Lumps or bumps arising from the head and neck region

In addition to performing a complete clinical assessment we have a comprehensive array of

diagnostic investigations at our disposal which include:

Thyroid & Neck Ultrasound

An ultrasound is a bed-side noninvasive scan that provides detailed information about

nodules arising from the thyroid gland allowing us to distinguish, very quickly, which
nodules are benign and which are likely to harbor cancer. It is useful to evaluate parathyroid,
parotid and salivary gland tumors as well. The ultrasound is also very valuable for assessing
swollen lymph nodes, neck cysts or other neck lumps, common clinical conditions that are
often benign, but which may, not infrequently, be the first presentation of a cancer within the
head and neck region.

Ultrasound-Guided Fine Needle Aspiration Biopsy

An ultrasound-guided fine needle aspiration biopsy (FNAB) is an office-based procedure

performed under local, or more frequently no anesthesia. The procedure involves the use of
the ultrasound to guide a very fine needle precisely into the nodule or lump, from which a
small amount of tissue is taken for tissue or histopathologic diagnosis. The procedure itself is
no different from blood taking, but with the needle inserted into the neck lump instead of into
an arm vein. Tissue diagnosis complements the findings of clinical and ultrasound
examination, and is the most accurate way determining if a thyroid nodule or neck lump is
benign, suspicious or confirmatory for a cancer.

The use of the ultrasound in performing the needle biopsy ensures precision in obtaining
tissue from the specific areas of abnormality in the nodule or lump. It also achieves a higher
cellular yield, which increases the diagnostic accuracy of the histopathologic assessment.

The Thyroid Head and Neck Surgery Centre is unique in providing these two essential
investigations at the same time and sitting as the office consultation.
Results of the tissue diagnosis are usually made available within one working day.

Fibreoptic Nasoendoscopy

A fibreoptic nasoeondosopy is an endoscopic procedure that is performed in the office under

local anaesthesia. It provides excellent direct visualization of the internal structures of the
nose, post-nasal space, oral cavity, throat and voice box. This procedure is particularly
important for the diagnosis of:

• Nasopharyngeal cancer (NPC), commonly referred to as "nose" cancer, and

• Squamous cell cancer (SCC), tumors arising from the upper respiratory and digestive tracts
related to
tobacco and alcohol use.

If necessary a small tissue sample or biopsy can be taken from the abnormal site for
histopathologic analysis.
(see NASOPHARYNX and HEAD & NECK DISEASE)

Diagnostic Radiology

Computerized Tomography (CT) scans, Magnetic Resonance Imaging (MRI) and PET-CT
scans are additional scans that are available in-house if required.

These scans are important for NPC, SCC and other cancers as they provide detailed
information about the size of the tumor, deep extent and involvement of critical structures in
the vicinity, and spread to lymph nodes in the neck or remote regions of the body, allowing
us to define and stage the cancer accurately.

One-Stop Services At A Glance:

• Comprehensive head & neck evaluation and fibreoptic nasoendoscopy

• Blood biochemistry (thyroid function test, parathyroid assays, EBV serology etc)
• Thyroid Ultrasound
• Ultrasound-Guided Fine Needle Aspiration Biopsy
• Tissue biopsy
• Diagnostic Radiology
• Computerized Tomography (CT)
• Magnetic Resonance Imaging (MRI)
• Positive Emission Tomography (PET -CT)