Name of the Procedure:

Excision of Cystic Hygroma, Axillary or Cervical; without Deep Neurovascular Dissection

Summary

Excision of a cystic hygroma involves surgically removing a fluid-filled sac that commonly appears in the neck (cervical) or underarm (axillary) area. This procedure is done without deep dissection around major nerves or blood vessels.

Purpose

The procedure addresses cystic hygromas, which are benign cysts often present from birth. The goals are to remove the cyst to prevent complications such as infection, difficulty breathing or swallowing, and to improve cosmetic appearance.

Indications

• Presence of a cystic hygroma that is causing symptoms such as swelling, pain, or difficulties with breathing or swallowing.
• Recurrent infections within the cyst.
• Cosmetic concerns due to noticeable swelling.
• Growth or change in the cyst suggesting potential complications.

Preparation

• Patients may need to fast for several hours before the procedure.
• Blood tests may be required to assess overall health.
• Imaging tests like ultrasound or MRI may be conducted to better visualize the cyst.
• Patients should inform their doctor of any medications they are taking, as some may need to be paused or adjusted.

Procedure Description

1. The patient receives general anesthesia to ensure they are asleep and pain-free.
2. A surgical incision is made over the cystic hygroma area.
3. The surgeon carefully dissects around the cyst, avoiding deep neurovascular structures.
4. The cyst is removed completely.
5. The incision is closed with sutures and a sterile dressing is applied.

Duration

The procedure typically takes 1 to 3 hours, depending on the size and location of the cyst.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• A surgeon specialized in this type of excision.
• An anesthesiologist to administer and monitor anesthesia.
• Surgical nurses and support staff.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Scarring.
• Damage to surrounding tissues, although avoidance of deep neurovascular structures reduces this risk.
• Recurrence of the cyst.

Benefits

• Relief from symptoms caused by the cyst.
• Reduction in the risk of infection and other complications.
• Improved cosmetic appearance.
• Benefits are often realized immediately, with full recovery expected in weeks.

Recovery

• Patients may go home the same day or stay overnight for observation.
• Pain can be managed with prescribed medications.
• Physical activity may be restricted for a few weeks.
• Follow-up appointments are necessary to monitor healing and remove sutures if needed.

Alternatives

• Observation for small, asymptomatic cysts.
• Sclerotherapy, where a solution is injected to shrink the cyst.
• Laser therapy.
• Pros and cons: Non-surgical options may be less invasive but could be less effective for large or symptomatic cysts.

Patient Experience

• The patient will be asleep and pain-free during the procedure due to general anesthesia.
• Postoperative pain and swelling are common but manageable with medications.
• Patients should expect a recovery period involving rest and minimal physical strain for several weeks to ensure proper healing.