Differential Diagnosis for a Mass in the Throat with Radiation to the Ear and Uvular Deviation

• Single Most Likely Diagnosis
  • Peritonsillar abscess: This condition is a collection of pus behind the tonsils that can cause a mass effect in the throat, radiate pain to the ear due to shared nerve pathways, and lead to uvular deviation due to the swelling and displacement of surrounding tissues.
• Other Likely Diagnoses
  • Tonsillar cancer: Although less common, cancer of the tonsils can present as a mass in the throat, cause ear pain due to referred pain, and lead to uvular deviation if the tumor is large enough to displace the uvula.
  • Quinsy (complicated peritonsillar abscess): This is an extension of the peritonsillar abscess into the parapharyngeal space, which can cause more severe symptoms including significant uvular deviation and radiating ear pain.
  • Retropharyngeal abscess: An abscess in the retropharyngeal space can cause a mass effect in the throat, lead to uvular deviation, and radiate pain to the ear.
• Do Not Miss Diagnoses
  • Epiglottitis: Although it typically presents with more severe symptoms like difficulty swallowing and shortness of breath, epiglottitis can cause a mass effect and uvular deviation. It's a medical emergency due to the risk of airway obstruction.
  • Parapharyngeal space infections: Infections in this space can spread to vital structures and cause significant morbidity or mortality if not promptly treated.
• Rare Diagnoses
  • Branchial cleft cysts: These congenital anomalies can present as a mass in the throat and, although rare, could potentially cause uvular deviation and radiate to the ear if they become infected or large enough.
  • Thyroglossal duct cysts: Although typically found in the midline, these cysts can occasionally present off midline and cause a mass effect that could potentially lead to uvular deviation and ear pain if they become infected.