Hydrocystoma of neck
Introduction
Introduction to cervical water cyst Hygroma (hygroma), also known as congenital cystic hydroma, cystic lymphangioma (cysticlymphangioma) is a congenital disease derived from lymphoid tissue can occur in all parts of the body, but the neck is most common. Mostly soft, fluctuating, painless mass, not easy to be compressed, good light transmission. Intracapsular injection is effective, safe and convenient, and is the first choice for clinical treatment. It is a common disease in newborns and infants. It has occurred in the neonatal period and has been neglected because of its small size and no obvious clinical manifestations. More than 90% of patients were found within 2 years of age. The incidence rates for men and women are basically similar. Seventy-five percent of the water cystic tumors occur in the neck, and the rest are large omental cysts and mesenteric cysts such as the infraorbital, chest wall mediastinum, retroperitoneal, pelvic and groin. Although the cystaea is a benign lesion, it can infiltrate into the surrounding tissue or even the main organs. It may cause life-threatening complications in a short period of time. Therefore, most of the cysts should be treated actively. If the lesion is small, there is no symptom. The child can be followed up for 1 to 2 years. basic knowledge The proportion of illness: 0.0005% Susceptible people: newborns and babies Mode of infection: non-infectious Complications: Upper respiratory tract infection Dysphagia
Cause
Causes of cervical water cyst
In the congenital malformation of lymphoid tissue, the junction of the internal jugular vein and the subclavian vein expands to form a cystic cavity called the cervical sac. Part of the lymphatic system develops from the cervical sac. During the development of the embryo, if a part of the lymphoid tissue disappears and remains embryonic, it continues to develop and enlarge. It contains the lymphatic fluid and the multi-sac sac with the endothelium. It forms a cystic water tumor.
Prevention
Cervical cyst tumor prevention
1. Prevention:
There is currently no effective way to prevent early detection and early diagnosis is the key to treatment.
2. First aid (mitigation measures):
The actual lesion range of cystic lymphangioma often exceeds the original estimate. It is often difficult to completely remove the surgery. The surgery requires careful dissection of the important nerves, blood vessels and other structures in the neck. Prevent facial nerve paralysis and lingual nerve, recurrent laryngeal nerve, and radial nerve injury, causing difficulty in breathing and hoarseness. For the remaining wall, 0.5% iodine can be applied to destroy endothelial cells to prevent recurrence.
Complication
Cervical cysticoma complications Complications, upper respiratory tract infection, difficulty swallowing
1. Cystic tumor infection: mild upper respiratory tract infection or local minor injury can cause cystic tumor infection. At this time, there may be local and systemic infection symptoms, which are difficult to control.
2. Cyst tumor hemorrhage: local infection and injury can cause a sudden increase in cystic hemorrhage cyst, and the intracapsular tension is increased, which may cause symptoms of tracheal and esophageal compression.
3. Tracheal compression: cystic lymphangioma under the fascia extends to the mediastinum, or cystic hemorrhage can cause compression of the trachea, causing dyspnea in children.
4. The cystic tumor wrapped in the pharynx can cause difficulty swallowing.
Symptom
Symptoms of neck water cyst tumors Common symptoms Head and neck activity restricted tumor block compression dyspnea neck lymph node enlargement dysphagia neck cystic lesion
Most of the neck masses that can be seen at birth are mostly found in the posterior border of the sternocleidomastoid muscle. The posterior cervical collar is a good site, and a few can occur in the anterior triangle. The protruding skin is generally 4 to 6 cm in diameter, smooth and soft, with obvious undulation, no tenderness, and many unclear edges. The covered skin may be unchanged or light blue due to subcutaneous fluid accumulation. Positive.
When the water tumor is too large, the head and neck activities are limited. The inward expansion of the water tumor can compress the throat and the trachea, causing difficulty in breathing. If the water tumor located in the anterior triangle of the neck protrudes upward from the bottom of the entrance cavity, it can affect the chewing and swallowing movement.
Water sac tumors have the potential and long-term slow growth characteristics. When the upper respiratory tract infection occurs, the water tumor can suddenly increase. This may be caused by the infection causing obstruction of the lymphatic vessels and causing the lymph to flow back into the cyst. Mild trauma caused by internal bleeding can also suddenly increase the water tumor. Cystic hydromas also have the property of "invasive" growth along the vascular nerve, but rarely cause compression symptoms.
Examine
Examination of cervical water cyst
Iodine angiography of water cysts. Preoperative iodine angiography of water tumors helps to understand the extent of the cystic tumor and its branches, and has reference value for surgical resection.
Methods: The water cyst was puncture, and 10 to 15 ml of lymph was taken out, and the same amount of contrast agent was injected, and then the film was taken.
Diagnosis
Diagnosis and differentiation of cervical water sac tumor
diagnosis
The diagnosis of cystic water tumors is mainly based on medical history and symptoms. The light transmission test was positive because the cyst wall was thin and contained a colorless liquid. The puncture can be pumped out of the grass, which is transparent and easy to coagulate. It has cholesterol crystals and has the same properties as lymph.
Differential diagnosis
It is differentiated from lymphangioma and cystic lymphangioma.
