Treatment of choice for cystic hygroma
Ans. d (Surgical excision) (Ref. Bailey and Love Surgery 25th/pg. 729).Definitive treatment of Cystic hygroma is complete excision of the cyst at an early stage. Injection of a sclerosant , may reduce the size of the cyst; however, they are commonly multicystic and if the injection is extracystic subsequent surgery may be more difficult.CYSTIC HYGROMA# In this developmental abnormality of the lymphatic system, lymphatic fluid collects in a cystic space which is often multilocular and situated in the base of the neck (post triangle).# Association with Turner's syndrome is known.# Cystic hygroma usually presents in the neonate or in early infancy, and occasionally may present at birth and be so large as to obstruct labour. The cysts are filled with clear lymph and lined by a single layer of epithelium with a mosaic appearance. Swelling usually occurs in the neck and may involve the parotid, submandibular, tongue and floor of mouth areas. The swelling may be bilateral and is soft and partially compressible, visibly increasing in size when the child coughs or cries. The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent.# The cheek, axilla, groin and mediastinum are other less frequent sites for a cystic hygroma.# The behaviour of cystic hygromas during infancy is unpredictable. Sometimes the cyst expands rapidly and occasionally respiratory difficulty ensues, requiring immediate aspiration and even occasionally a tracheostomy. The cyst may become infected.# USG can be diagostic.
Percutaneous aspiration
Intralesional sclerosant injection
En bloc resection
Surgical excision
Neck