Head and Neck Fellowship Trained
Barts and The Royal London Hospital
The Royal Marsden Hospital
UCL Dinant Godinne
Professors Marc Remacle and Georges Lawson
Head & Neck Surgery Singapore — Dr Vyas Prasad
Head and neck surgery is one of the most varied and technically demanding subspecialties in medicine. It spans an enormous range of conditions — from a benign cyst discovered incidentally on a scan, to a complex tumour involving multiple structures of the face and neck. What these conditions share is their location: a region dense with critical anatomy, including the major blood vessels, the airway, the nerves of the face and voice, and the glands that regulate metabolism and calcium.
Dr Vyas Prasad is a Consultant Otolaryngologist and Head & Neck Surgeon with subspecialty training across the full scope of this field. He assesses and manages both benign and malignant head and neck conditions at Camden Medical Centre, working within a multidisciplinary framework where complex cases require it — and offering clear, unhurried assessment for patients who simply want to understand what they are dealing with.
What Head & Neck Surgery Covers
The head and neck region encompasses a wide range of structures, each with its own set of conditions. Dr Prasad's practice covers:
- Neck lumps and lymph node swellings: The most common reason for head and neck referral — from reactive lymph nodes to lymphoma, metastatic cancer, and congenital cysts.
- Salivary gland disorders: Including stones, infections, and tumours of the parotid, submandibular, and sublingual glands.
- Thyroid and parathyroid conditions: Nodules, goitre, thyroid cancer, Graves' disease, and hyperparathyroidism — covered in detail on the dedicated thyroid page.
- Head and neck cancer: Including cancers of the larynx, nose and sinuses, ear, throat (including the nasopharynx), oral cavity, salivary glands, and skin of the head and neck.
- Skin lesions of the head and neck: Basal cell carcinoma, squamous cell carcinoma, melanoma, and other lesions requiring surgical management in a cosmetically sensitive region.
- Facial nerve conditions: Including facial nerve palsy, tumours involving the facial nerve, and parotid surgery requiring nerve identification and preservation.
- Congenital neck cysts and masses: Thyroglossal duct cysts, branchial cysts, dermoid cysts, and vascular malformations.
- Skull base lesions: Conditions affecting the base of the skull presenting with cranial nerve symptoms, hearing change, or facial numbness.
- Swallowing and airway conditions: Including pharyngeal pathology, airway compromise from neck masses, and Zenker's diverticulum.
Conditions in Detail
Neck Lumps & Lymph Node Swellings
The neck is home to hundreds of lymph nodes: reactive lymphadenopathy (infection-related), lymphoma (cancer of the lymphatic system), metastatic cancer (cancer spreading from elsewhere in the head and neck), salivary gland tumours, or thyroid nodules or cysts. In a specialist ENT clinic, these are usually investigated using ultrasound and, if necessary, a fine-needle aspiration (FNA) or core biopsy. Differential diagnoses include reactive cases and persistent lumps requiring urgent inquiry.
Salivary Gland Disorders
The major salivary glands — the parotid (in front of the ear) and the submandibular (under the jawline) — can be affected by various pathologies. Blockages, usually from stones (sialolithiasis) or chronic inflammation, can cause painful swelling after eating. More significantly, tumors can arise within these glands. In the parotid gland, 80% of tumors are benign, but in smaller salivary glands, the percentage of malignant cases is higher. Management often involves high-resolution imaging and precise surgical removal, ensuring the preservation of the nearby nerves.
Head & Neck Cancer
Head and neck cancer refers to malignant growths in the throat, lips, mouth, nose, and salivary glands. Tobacco and alcohol use were historically the primary risk factors, but human papillomavirus (HPV) is now a leading cause, particularly in cancers of the tonsils and base of tongue. Multi-disciplinary management is essential, and outcomes have significantly improved with early detection. Symptoms that warrant urgent assessment include a persistent sore throat or hoarseness lasting more than 3 weeks, unexplained difficulty or pain when swallowing, non-healing oral ulcers, or persistent neck lumps.
Skin Lesions of the Head & Neck
The face and neck are highly exposed to the sun, leading to a high frequency of skin cancers like Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma. Surgical management in this region requires a specialized approach that balances oncological safety with aesthetic restoration. Dr Prasad performs surgical excisions and reconstructive repairs, including local skin flaps and grafts, to ensure optimal functional and cosmetic results.
Facial Nerve Conditions
The facial nerve (CN VII) controls all movements of expression on the face. It passes directly through the parotid gland, making its protection paramount during salivary gland surgery. Conditions affecting the nerve include Bell's palsy, Ramsey Hunt syndrome, and compression from tumors. Assessment of facial nerve function requires meticulous neurological examination and imaging to determine the level and cause of injury.
Congenital Neck Cysts & Masses
Congenital masses manifest clinically as thyroglossal duct cysts (midline lumps moving with swallowing), branchial cysts (on the side of the neck), dermoid cysts, or cystic hygromas (vascular malformations). These masses are present from birth but may not appear until signs manifest during younger adulthood. Expert assessment is required to differentiate these from common reactive swellings.
How Assessment Works
Assessment of a head and neck condition is thorough and systematic. At your consultation, Dr Prasad will:
1
Take a detailed history
the duration, character, and behaviour of the lump or symptom, and any associated symptoms including voice change, swallowing difficulty, weight loss, or night sweats
2
Examine the head and neck clinically
palpating the neck, examining the oral cavity and throat, and assessing the cranial nerves where indicated
3
Perform flexible nasolaryngoscopy in clinic where relevant
a quick, well-tolerated endoscopic examination of the nasal passages, throat, and voice box
4
Arrange ultrasound imaging for most neck and salivary gland presentations
the first-line investigation for characterising soft tissue masses
5
Arrange FNAC (fine-needle aspiration cytology)
for lymph nodes or salivary gland swellings where tissue sampling is indicated
6
Request CT, MRI, or PET-CT imaging
for complex cases or where deep neck, skull base, or malignant involvement is suspected
What to expect at your first visit:
Most consultations last around 30–45 minutes. Flexible nasolaryngoscopy is quick and well tolerated, and any scans or procedures are only arranged after you’ve had a chance to ask questions and understand the plan.
At each stage, Dr Prasad explains findings clearly and discusses the next steps before any investigations or procedures are arranged. The goal is never to over-investigate — but to gather the information needed to give patients a clear, evidence-based answer.
Not sure what your neck or head and neck symptoms mean?
If you’ve noticed a neck lump, persistent throat or swallowing symptoms, or other head and neck concerns, a focused specialist assessment can help clarify what’s going on.
Dr Prasad offers clear, unhurried consultations at Camden Medical Centre in Singapore, with access to on-site imaging and a full multidisciplinary team where needed.
Why Patients Choose Dr Prasad for Head & Neck Care
Head and neck surgery requires specific training and experience beyond general ENT. The anatomical complexity of the region — major vessels, cranial nerves, the airway and voice — demands a surgeon who operates in it regularly and understands its demands.
Subspecialty head and neck surgical training:
Including experience at specialist oncology and head and neck surgery centres in the United Kingdom.
Laryngology expertise:
As a subspecialist in voice and laryngology, Dr Prasad has particular expertise in the airway and voice box — important in head and neck cases involving the larynx, trachea, or recurrent laryngeal nerve.
Same-visit assessment:
Flexible laryngoscopy and clinical examination at the consultation — most patients leave with a working diagnosis at the first visit.
Multidisciplinary coordination:
Complex cases are discussed with oncologists, radiologists, and reconstructive surgeons to ensure patients receive coordinated, evidence-based care.
Honest, unhurried consultation:
Patients with a neck lump are often anxious. Dr Prasad takes time to explain findings clearly and answer questions fully — without rushing toward a procedure that isn't needed.
Frequently Asked Questions
I have a lump in my neck. Should I be worried?
Most neck lumps in adults are benign — reactive lymph nodes from a recent viral or bacterial infection are the most common cause and typically resolve within a few weeks. However, a lump that persists beyond two to three weeks without explanation, is growing, feels firm or fixed, or is associated with other symptoms should be assessed by a specialist. Clinical examination and a neck ultrasound can usually provide clear answers quickly.
What does parotid surgery involve and is it risky?
Parotidectomy is performed under general anaesthetic through a carefully placed incision in front of and below the ear. The key technical challenge is identifying and preserving the facial nerve — the nerve responsible for all facial movement — as it passes through the parotid gland. In experienced hands, the risk of permanent facial weakness is low. Temporary weakness after surgery is more common and usually resolves fully. Dr Prasad will discuss the specific risks relevant to your case before any decision is made.
What is the difference between a benign and malignant parotid tumour?
Benign parotid tumours — the most common of which are pleomorphic adenoma and Warthin's tumour — do not spread to other parts of the body. They still require surgical removal because pleomorphic adenoma can undergo malignant change over time if left. Malignant parotid tumours are less common but require more extensive surgery and often additional treatment. Imaging and in some cases FNAC helps characterise a parotid lump before surgery, though the definitive answer often comes from analysis of the removed tissue.
How quickly should a head and neck cancer be treated?
Head and neck cancers are generally treated as a priority once diagnosed — typically within four to six weeks of diagnosis in a managed care setting. The treatment plan is decided within a multidisciplinary team (MDT) meeting involving surgeons, oncologists, radiologists, and speech therapists. Early referral and prompt MDT review are the most important factors in ensuring timely treatment.
Can skin cancer on the face be removed without a visible scar?
All surgical excisions leave a scar — but in the head and neck region, incisions are placed along natural skin creases and tension lines where possible to minimise their visibility. Primary closure in well-vascularised facial skin often heals very well. For larger defects, reconstruction using local flaps is planned to restore both function and appearance. Dr Prasad will discuss the planned approach and likely cosmetic outcome before any procedure.
What is Bell's palsy and does it recover?
Bell's palsy is a sudden, one-sided facial weakness caused by inflammation of the facial nerve — most commonly following a viral illness. The exact cause is not always identified. The majority of patients recover well, particularly those who begin treatment with oral corticosteroids promptly after onset. Full recovery occurs in around 70–80% of patients within three to six months. Those with more severe or complete initial weakness may have a longer or less complete recovery. Assessment is important to exclude other causes of facial weakness.
Do you see children with head and neck conditions?
Yes. Congenital neck cysts — particularly thyroglossal duct cysts and branchial cysts — frequently present in childhood or early adult life. Neck lymph node swellings are also common in children following throat and ear infections. Assessment in children follows the same systematic principles as in adults, and surgical management is adapted appropriately for age and anatomy.
Book a Head & Neck Consultation
If you have any concerns regarding a neck lump, swallowing difficulties, or persistent symptoms in the head and neck area, Dr Prasad provides comprehensive, specialist assessment at Camden Medical Centre.
Dedicated clinical inquiry and same-visit endoscopy allow most patients to receive a working diagnosis or clear diagnostic path without unnecessary delay.
