Excision of cystic hygroma

Excision of cystic hygroma

cystic hygroma
 A cystic hygroma is a fluid-filled sac that develops as a result of a lymphatic system blockage. The most typical location is in the neck or head, however, it can occur elsewhere on the body. 

What is cystic hygroma and how does it affect you?

The cystic hygroma is a lymphatic lesion made up of a cluster of cysts that can appear anywhere on the body, though it most usually affects the head and neck (approximately 75% of the time) and the left side. Cystic hygromas, also known as cystic lymphangiomas or microcystic lymphatic malformations, are a type of hygroma. The majority (over 50%) are visible at birth, and about 80% to 90% are present by the age of two. Cysts smaller than 2 centimetres are classified as microcystic, while cysts larger than 2 centimetres are classified as macrocytic.


Causes of cystic hygroma

Genetic or environmental variables that encourage abnormal lymphatic vascular system development during embryonic development cause a cystic hygroma. It can happen on its own or as part of a genetic syndrome with other symptoms like Turner syndrome, Down syndrome, or Noonan syndrome. Adults may get it as a result of trauma or previous respiratory infections. The reason for many of these cases is unknown.


Symptoms and indicators of cystic hygroma

The symptoms and indicators of cystic hygroma differ depending on where the cyst cluster is located. Because so many are found in the neck, they can cause symptoms ranging from mild to severe. The following are the signs and symptoms of cystic hygroma:

  • On the buccal mucosa or the tongue, there are clusters of transparent, black, or red vesicles (microcystic form)

  • Large cysts with bluish or normal-looking skin overlying them (macro cystic form)

  • obstructive sleep apnea (sleep apnea)

  • problems with breathing

  • issues with food

  • Failure to Succeed (especially in children who have involvement of the gastrointestinal tract)

  • haemorrhage within the lesions (rare)


Diagnosis of cystic hygroma?

Some individuals have obvious lesions that allow the diagnosis to be made on inspection, whereas others do not. An MRI scan, CT scan, ultrasound, and occasionally even X-rays can be used to see the soft tissue lesions. Other methods have been utilised, such as airway fluoroscopy and lymphoscintigraphy (radiographic imaging lymph node mapping). Endoscopic biopsy has also been utilised to make a diagnosis.

Cystic hygromas in foetuses have been diagnosed with ultrasound as early as the first trimester.


What are the options for cystic hygroma treatment?

When a child has cystic hygroma but no symptoms, some specialists choose to "watch and wait." If symptoms arise, there are two basic treatments: medical, which involves the use of chemicals to scar or destroy cysts, and surgical excision of cystic tissue. According to some authors, surgical removal is the best option. The lesions have also been treated using various procedures such as radiofrequency ablation and laser-induced thermotherapy.


Surgical removal or Excision of cystic hygroma

Excision of complicated cystic hygromas, which involve deep and important issues, is a difficult task. To avoid post-operative problems, extreme caution must be exercised. Damage to the facial nerve, facial artery, carotid vessels, internal jugular vessels, thoracic duct and pleura, as well as partial excision in the case of infiltration to the surrounding structures, are all possible risks during surgery. Site infection, haemorrhage, hypertrophied scar, and lymphatic drainage from the wound are all post-operative problems seen after surgical excision of cystic hygroma. 

Even after apparent total excision of the lesion, recurrence occurs in roughly 20% of instances. Surgical removal of cystic hygroma is still the recommended approach in cases with life-threatening lymphangiomas and spontaneous bleeding, despite these potential risks. Surgical treatment is also preferred for intra-thoracic and intra-abdominal lesions.


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