There are several common causes of a hard pack in the neck below the ear: a. The patient’s local skin breaks are not disinfected in time, which can cause a local purulent infection and cause an inflammatory mass. Patients will be accompanied by obvious pain and elevated skin temperature. The size and scope of the inflammatory mass can be clarified by perfecting ultrasound examination. The self-absorption of the mass is promoted by applying topical Ruyi Jinhuang cream and vital iodine gauze. Patients with abscess formation need to perform abscess incision and drainage and strengthen anti-infection treatment to promote faster relief of hard masses. Secondly, metastatic hard masses caused by malignant tumor invasion, such as nasopharyngeal malignant tumor, esophageal malignant tumor, thyroid malignant tumor and so on. At this time, patients need to clarify the primary tumor lesion as soon as possible, and perform resection of tumor plus lymph node clearance for hard mass removal. After surgery, combined with chemotherapy and radiotherapy, patients with early disease can achieve better treatment results.