Aspiration and Sclerothrapy Cystic Hygroma Treatment in India

Aspiration cystic hygroma

Cystic hygroma (also known as lymphatic malformation) is a swollen area of the neck, armpit or jaw that is filled with fluid due to an abnormal lymphatic vessel. One of the minimally invasive methods to remove the fluid is aspiration which is done temporarily or in a sclerotherapy process.

Aspiration of Cystic Hygroma

Aspiration is a procedure that entails the removal of the fluid found in the cystic hygroma using a needle. It is typically done to:

• Decrease the edema in the short term.
• Take stress off surrounding buildings.
• Preparation of the lesion to sclerotherapy.
• Diagnose fluid nature (in uncommon instances of obscure diagnosis)

Aspiration is not a long lasting solution because the cyst in most cases fills up once more without any further treatment.

Aspiration of Cystic Hygroma -Indications

Aspiration is proposed where:

• The cystic hygroma is huge and raising cosmetic issues.
• Difficulty in swallowing or breathing (primary decompression).
• A reduction of cyst is necessary prior to sclerotherapy.
• Lesion infected (pus may have to be emptied).

Aspiration and sclerotherapy treatment

Cystic hygroma (lymphatic malformation) is a harmless, filled up swelling due to the anomaly of lymphatic channels. Combined, aspiration and sclerotherapy represent one of the most effective treatment methods that are minimally invasive, particularly when it comes to the large cysts (macrocystic) ones.

Aspiration and Sclerotherapy

Such a mixed method entails:

• Aspiration: Using a small needle to drain the fluid within the cyst.
• Sclerotherapy: The cyst is injected with a medication (sclerosing agent) that collapses and scars the cyst walls, preventing re-accumulation of fluid. 

The method is desirable in case of:

Macrocystic cystic hygromas

• There are lesions in the neck, face, axilla.
• Infants, children, and adults
• Patients that prefer not to undergo open surgery.

Aspiration and Sclerotherapy Procedure

Pre-Procedure Evaluation

• Ultrasound or MRI to determine the size of cysts and compartments.
• Blood tests if needed.
• General anaesthesia or local anaesthesia according to patient age (infant/child).

Step-by-Step Procedure 

Aspiration

• The skin is sterilized.
• The insertion of a fine needle or cannula is done under ultrasound.
• There is the removal of cyst fluid.
• This relieves the pressure and preconditions the sclerosant to the cyst.

Sclerotherapy Injection

• After it has been emptied, a sclerizing agent is injected in the cyst cavity.
• The lining becomes irritated and fibrotic due to the sclerosant - cyst collapses.
• Sclerosant amount varies according to the size of cysts, age, and agent.

Monitoring

• Observation of the patient takes 2-4 hours.
• Others might require day-care or sedation.

Number of Sessions

• The majority of the macrocystic lesions require 1-3 treatments.
• Microcystic lesions need additional sessions or a combination of treatment.
• Repeat of treatment or additional surgery may be necessary when dealing with mixed lesions.

Post-Aspiration + Sclerotherapy

• The swelling should take 2-5 days.
• Depending on the agent used, mild pain, redness, or fever may be experienced.
• Normal activity is normalized in 1-3 days.
• Subsequent scans are carried out after 4-6 weeks.

Cystic hygroma aspiration procedure

Cystic hygroma (lymphatic malformation) is a fluid filled swelling, which occurs as a result of defective lymphatic channels. Aspiration is a non-invasive, comparable technique conducted to extract the liquid in the cyst. It is mostly performed as a temporary solution or as an initial measure prior to sclerotherapy.

A Cystic Hygroma Aspiration Procedure

Aspiration procedure entails placing a thin needle or cannula in the cyst and draining the fluid with the help of ultrasound. This minimizes the swelling size and alleviates the symptoms of pressure, pain, or dyspnea/dysphagia. But the fact of aspiration is not a lifetime cure as the cyst tends to fill up.

Aspiration Step-by-Step Procedure

Pre-Procedural Evaluation

• To determine the size of the cysts, depth of the cysts and the compartments, ultrasound is conducted.
• Infants/children are put under general anaesthesia and adults under local anaesthesia are adequate.
• The zone is sterilized and covered with a sterile.

Positioning and Preparation

• Patient is placed according to the position of the cyst (neck/axilla/face).
• Antiseptic solution is put on the skin.
• The entry point is guided by Ultrasound probe.

Needle Insertion

• A thin needle (mostly 18-22 gauge) or cannula is inserted in the cyst.
• The positioning is done well with ultrasound to prevent vessels or nerves.
• Fluid starts to flow the moment the needle penetrates into the cyst.

Aspiration of Cyst Fluid

• A slow aspiration of the cystic fluid into a syringe takes place.
• One can use multiple syringes to deal with large cysts.
• Aspiration is done until the cavity is emptied.
• Fluid can be referred to have it analysed when necessary (not often needed).

Post-Aspiration Management

• The process concludes with the application of light pressure and a sterile dressing in case aspiration is performed exclusively.
• Should be used with sclerotherapy, a sclerosant is injected right after aspiration.
• Monitoring of patient 30 minutes to 2 hours.

Recovery After Aspiration

• Minor pain or tenderness in 1-2 days.
• Suffering is very moderate and can be treated using simple analgesics.
• Normal operations may be reinstated in a short time.
• The follow-up ultrasound can be arranged to check refilling.

Cystic hygroma sclerotherapy success rate

Sclerotherapy has become the initial choice of management of the cystic hygroma (lymphatic malformation) particularly of macrocystic type. The success rates differ with the type of lesion, agent to use, and sessions.

Overall Success Rates

Macrocystic Cystic Hygroma

• 85–95% success rate
• Best response because of large single or few cyst chambers.

Microcystic Cystic Hygroma

• 40–60% success
• Harder due to the presence of numerous small cysts.
• Frequently involves multiple operations or surgery.

Mixed (Macro + Microcystic) Lesions

• 60–80% success
• The results will be determined by the prevailing component.

Best hospital for cystic hygroma treatment India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

Cystic hygroma is a variable malformation made up of lymphatic tissue that is easily treated by minimally invasive treatment. The aspiration can be used to help in the eventual reduction of the swelling by the removal of accumulated fluid though it does not address the situation permanently. Instead, sclerotherapy is a very successful and secure long-term treatment, particularly when treating macrocystic lesions. Sclerotherapy has succeeded with a success rate of 85-95, and it is now the first-line therapy, which has eliminated the open surgery and its related dangers. Early diagnosis, proper imaging, and treatment by the experts will ensure high cosmetic and functional results hence aspiration, followed by sclerotherapy, is a feasible and efficient intervention in the management of cystic hygroma.

Aspiration and sclerotherapy cystic hygroma India GetWellGo

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FAQ

Is aspiration sufficient treatment for cystic hygroma?

• No. Aspiration is just removing the fluid temporarily. The cyst refills usually unless it is followed by sclerotherapy.

What should I expect after the procedure?

• Mild swelling, redness and low-grade fever may be seen for 2–5 days. These are usual reactions to the sclerosing agent.

Can cystic hygroma recur after sclerotherapy?

• Recurrence is rare following successful sclerotherapy, particularly in the macrocystic type. Mixed or microcystic cysts may necessitate multiple therapies.

Is surgery needed?

• Surgery is reserved for when sclerotherapy fails or if the lesion is complex, very large, or microcystic.

Is sclerotherapy safe for infants and children?

• Yes. It is commonly performed in pediatric patients and has an excellent safety profile when carried out by trained pediatric surgeons or interventional radiologists.