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Incision and drainage of thyroglossal duct cyst, infected

CPT4 code

Name of the Procedure:

Incision and Drainage of Thyroglossal Duct Cyst, Infected

Summary

This procedure involves making a small cut to drain an infected cyst located in the thyroglossal duct, a remnant of the developmental tract in the neck. The goal is to remove the infection and reduce any discomfort or swelling.

Purpose

This procedure addresses the presence of an infected thyroglossal duct cyst, which can cause pain, swelling, and sometimes difficulty swallowing or breathing. The expected outcome is the reduction of infection and relief from these symptoms.

Indications

  • Presence of a painful, swollen lump in the neck.
  • Signs of infection such as redness, warmth, and drainage of pus.
  • Difficulty swallowing or breathing due to the cyst.

Preparation

  • Patients may need to fast for a few hours before the procedure.
  • Adjustments to current medications should be discussed with the healthcare provider.
  • Blood tests or imaging studies (e.g., ultrasound, CT scan) may be required to assess the cyst.

Procedure Description

  1. The patient will be positioned comfortably, often lying down.
  2. Local anesthesia is administered to numb the area.
  3. The surgeon makes a small incision over the cyst.
  4. The infected fluid is drained, and the cyst may be irrigated to remove any remaining debris.
  5. A small drain may be placed to allow continuous drainage and prevent fluid accumulation.
  6. The incision is closed with sutures or left open to drain, depending on the case.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

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

Personnel

  • Surgeon
  • Surgical nurse
  • Anesthesiologist (if general anesthesia is used)

Risks and Complications

  • Infection at the incision site
  • Bleeding or hematoma
  • Recurrence of the cyst
  • Scarring
  • Nerve damage (rare)

Benefits

  • Relief from pain and swelling
  • Resolution of infection
  • Improved swallowing and breathing

Recovery

  • Post-procedure, the patient may be given antibiotics to prevent infection.
  • Pain can be managed with prescribed medications.
  • Patients are advised to keep the area clean and dry.
  • Follow-up appointments are necessary to monitor healing.
  • Recovery time is generally 1-2 weeks, with some restrictions on strenuous activities.

Alternatives

  • Antibiotic therapy to treat infection without drainage.
  • Sclerotherapy (injection of a substance to shrink the cyst).
  • Complete surgical removal of the thyroglossal duct and cyst (Sistrunk procedure).
  • Each alternative has its own pros and cons concerning invasiveness, effectiveness, and recovery time.

Patient Experience

  • During the procedure: minimal discomfort due to local anesthesia; if sedation or general anesthesia is used, patient will not feel pain.
  • After the procedure: mild to moderate pain at the incision site, manageable with pain relievers.
  • Patients may feel some discomfort when swallowing or moving the neck, which typically improves as healing progresses.

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