Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
CPT4 code
Name of the Procedure:
Excision of Branchial Cleft Cyst or Vestige, Confined to Skin and Subcutaneous Tissues
Summary
In this minor surgical procedure, a cyst or remnant from a branchial cleft is removed from under the skin. Branchial cleft cysts are congenital (present from birth) and can sometimes cause swelling or discomfort.
Purpose
This procedure addresses the removal of branchial cleft cysts or vestiges, preventing potential infections, discomfort, and cosmetic concerns. The goal is to completely excise the cyst or vestige to prevent recurrence and provide relief from any associated symptoms.
Indications
- Swelling or lump in the neck or near the collarbone
- Pain or discomfort in the cyst area
- Recurrent infections or drainage from the cyst
- Request for removal due to aesthetic concerns
Preparation
- Patients may need to fast for a few hours before the procedure.
- Adjustments to regular medications might be necessary.
- A physical examination and imaging tests (like ultrasound or CT scan) may be required to assess the cyst's size and location.
Procedure Description
- The patient is positioned comfortably, and the area around the cyst is cleaned and sterilized.
- Local anesthesia is administered to numb the area.
- A small incision is made over the cyst.
- The cyst or vestige is carefully separated from surrounding tissues and excised.
- The incision is then closed with sutures.
- A sterile dressing is applied to cover the wound.
Tools & Equipment: Scalpel, surgical scissors, forceps, sutures, and sterile dressings.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is performed in an outpatient clinic or surgical center.
Personnel
- Surgeons (typically an ENT specialist or general surgeon)
- Nurses or surgical assistants
- Anesthesiologist (if general anesthesia is required, though typically not necessary for this procedure)
Risks and Complications
- Infection at the incision site
- Bleeding or hematoma formation
- Scarring
- Recurrence of the cyst if not completely removed
- Nerve damage, though rare
Benefits
- Relief from discomfort or pain caused by the cyst
- Lowered risk of infection
- Improved cosmetic appearance
- Typically, benefits are realized immediately or within a few days after the procedure.
Recovery
- Follow post-procedure care instructions such as keeping the wound clean and dry.
- Over-the-counter pain medication may be used to manage discomfort.
- Generally, patients can return to regular activities within a few days to a week.
- A follow-up appointment may be scheduled to check the healing process and remove sutures if necessary.
Alternatives
- Observation: In some cases, asymptomatic cysts can simply be monitored.
- Aspiration: Drawing the fluid from the cyst with a needle, though this often leads to recurrence.
- Antibiotics: For infected cysts, although this does not remove the cyst itself.
Patient Experience
During the procedure, patients should feel minimal pain due to local anesthesia. Some pressure or tugging sensations might be felt. Post-procedure, there may be mild discomfort or swelling, which can be managed with pain relief medication and proper wound care.