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A ganglion cysts or a synovial cyst also known as Gideon’s disease, is a non-cancerous lump that tends to appear near the joints or tendons. It is most commonly found on the wrist or hands, more rarely they occur in the ankle region.
Synovial cysts, posttraumatic degeneration of connective tissue, and inflammation have been considered as the main causes. Other possible mechanisms for the development of ganglion cysts include repeated mechanical stress, facet arthrosis, increased production of hyaluronic acid by fibroblasts, and a proliferation of mesenchymal cells.
Ganglion cysts can affect anyone at any time, but they are most commonly found to occur in females, especially between 20 and 40 years of age. People who vigorously use certain joints are more likely to develop ganglion cysts, such as Gymnasts and other athletes who repeatedly put their wrist under stress.
If a cyst presses on a nerve — even if the cyst is too small to form a noticeable lump — it can cause pain, tingling, numbness or muscle weakness. Surgical treatments remain the primary elective option for treatment of ganglion cysts. The progression of ganglion surgery worldwide is to use an arthroscopic or mini-opening method. If you experience a noticeable lump or pain in your wrist, hand, ankle or foot, consult a surgeon who can make a diagnosis and determine whether you need treatment.
The surgical excision of a ganglion can be performed under a local anesthesia, intravenous anesthesia or a general anesthesia. Following administration of anesthesia an incision is placed centered over the mass and a camera is inserted into the affected area. Care must be taken to protect any skin nerves in this area. The mass is dissected from the surrounding soft tissues and removed. The ganglion mass has a tail that extends from the joint or tendon sheath that it arises from.
During the dissection of the mass the tail is identified. Once the tail has been identified and cut the area of exit from the joint or tendon sheath is closed with suture or electrocautery. Following the placement of sutures to close the surgical site a gauze compressive dressing is applied. The arthroscopic surgery or keyhole surgery minimizes the surgery’s impact on the patient. This final method is currently the most successful in terms of reducing cyst recurrence.
Patients with severe ganglion cysts can benefit from surgical removal. Some patients never experience pain or limited movement because of their cysts, so they do not require surgery. When a cyst gets large and cannot be treated by other methods, surgical removal can provide relief.
While it does not eliminate the chance of cysts completely, surgery removes the source of discomfort.
Like any surgery, ganglion cyst removal poses a risk of infection. The surgeon may prescribe an antibiotic to prevent the infection from spreading. Patients are encouraged to keep their dressing and wounds clean to prevent infection and minimize scarring.
Patients may experience an allergic reaction to the anesthesia used in the removal, or to the stitches used to seal the removal site. Most people who have a ganglion cyst removed heal quickly and without difficulty.
Be sure to tell your health care provider if you’ve been experiencing any pain and if the ganglion has changed in size. You doctor will likely apply pressure to the cyst to see how sensitive it is. Since ganglions are filled with a jelly-like fluid, your physician may shine a light on the ganglion to see whether light can pass through. After these these quick diagnostic tests, your surgeon will likely have enough information to make a diagnosis and recommend the appropriate treatment.
If your doctor decides that surgery is the best option, follow his or her instructions to prepare for surgery.
Depending on what type of anesthesia you will be receiving, you may be told not to eat or drink anything after midnight, the night before your surgery. Your surgeon may also request that you stop taking certain medications before the excision.
The recovery period depends upon the location of the ganglion and the amount of dissection required in removing it.
The patients are seen for their first follow up visit in 3 – 7 days, depending on the surgeon’s preference. On the first visit the surgeon checks the surgical site and the bandage is reapplied. The sutures are removed in 10 – 14 days following the day of surgery.