Diagnosis
First, in addition to an examination of the affected area, a physical examination by the doctor should be performed. When looking at the lymph node region, attention should be paid to redness and possible fistula formation (gait).The physical examination is the simplest and at the same time a very effective way of examining swollen lymph nodes. During the physical examination, the examiner palpates the individual lymph node regions with his fingers, which in medicine is called palpation.
During the palpation examination, the affected lymph node should be examined with regard to its size, mobility, consistency and possible pressure pain. A malignant change in the lymph nodes is when they are enlarged, hardened, painful and only slightly movable in relation to the surrounding area. A laboratory examination of the blood can be considered as a further diagnostic measure.
Here, for example, an inflammation can be noticed, which is usually manifested by an increased CRP (C reactive protein), an inflammation protein, and an increased leukocyte value, i.e. the white blood cells. As a further option in diagnostics, an ultrasound examination of the enlarged lymph nodes can follow. This can determine whether the enlargement is benign or malignant. In addition, possible pus formation can be seen. Finally, the lymph nodes can be surgically removed and then sent for examination to a pathologist, who will examine them with a microscope, for example, to determine their structure, growth behavior and composition.
Duration
The duration of the swollen lymph nodes behind the ear depends mainly on the cause of the lymph node swelling. If the cause is bacterial or viral, the swelling will continue until the disease has healed. This is due to the fact that the immune system works until the germ is defeated and only stops multiplying once the germ has healed and the defense cells in the lymph node are stopped.
The same applies to other temporary inflammatory or immunological processes. For example, if an inflammation on the tooth is responsible for the swelling of the lymph nodes, these will also be enlarged and painful until the cause has been treated and eliminated. It is also possible that enlarged lymph nodes no longer recede properly or therefore remain perceptible.
This is not serious and rather indicates a strong reaction of the immune system in which the lymph node tissue has increased. If the lymph nodes remain swollen for more than three to four weeks without any noticeable inflammation, and if they also become larger in the course of time, the patient should consult his or her family doctor. In general, swollen lymph nodes that are palpable should not cause agitation.
It is possible that after an infection they will not become as small as they were before the inflammation. This is simply because the tissue often does not completely regress after an immune reaction. Nevertheless, after 4 weeks of existing lymph node swelling – whether behind the ear or elsewhere on the body – patients should consult a doctor who can rule out a possible dangerous cause.
Permanently swollen lymph nodes can also be diseases of the immune system, such as HIV, in which the immune system is constantly fighting the HIV virus and is therefore continuously active, which can lead to permanently swollen lymph nodes behind the ear. Lymph nodes can also be enlarged in diseases of the lymphatic system. These include malignant diseases such as lymphomas (cancer in the lymph nodes).
Other cancers that spread to the lymph nodes can also cause them to swell. In most cases, the lymph nodes are caked to the surrounding tissue and are not painful. If the cancer spreads into the retroauricular lymph nodes, it is usually a malignant tumor of the back or side of the head, the auricle or the auditory canal. However, these tumors are generally very rare.
