Is it necessary to remove side cysts neck. Side Cyst Neck Q77 osteochondroflasis with defects for the growth of tubular bones and spine

Teratoma Consist of structures that are not characteristic of the part of the body where such education is located.

Code for the international classification of diseases of the ICD-10:

D17.0.
D21.0.

Types . Epidermoid cysts occur more often than other terats. They are sedated with multi-layer flat epithelium, additive structures, as a rule, do not contain. Deroid cysts - cavities covered with multi-layer epithelium and containing skin appendages (for example, hair, glandular cloth). Theratoid cysts are lined with epithelium and filled with a ray-like mass. The head and neck are rare localization.

Theratomas are usually diagnosed immediately after birth, rarely after the first year of life. Characteristic .. The size of education is usually 5-12 cm in the largest measurement, the contents of the semi-liquid, sometimes dense .. In children with cervical dermoids, stridorous breathing, suffocity and cyanosis are common due to compression or trachea shift. Possible dysphagia .. some children have no symptoms at birth, but they arise in a few weeks or months. Treatment - removal by teratom in early childhood.

Malignized teratomas on the neck are rare, more often arise in adults. The forecast is extremely unfavorable.

Vascular tumors
Hemangioma - The most common tumor of the head and neck in children. Girls suffer more than boys. The defeat is usually single.

. Types of hemangiom .. Capillary hemangiomas ... rarely occur in adults ... can appear suddenly and achieve large sizes, after which they often regress .. Cavernous hemangiomas are more constant in size. Spontaneous regression more often undergo hemangioma, detected at birth than those who emerged later .. Arteriovenous hemangiomas arise exclusively in adults, selectively affect the lips and skin of the mouth of the mouth .. Invasive hemangiomas are located in deep subcutaneous fabrics, fascial layers and muscles ... look like infiltrates on The neck, more often arise in children ... tend to recurrence after removal, but do not metastasize ... more often the chewing and trapezoid muscles are striking ... intramuscular hemangioma usually detect in youthful age. When palpation, they are movable and dense. As a rule, there is no noise and pulsation over them. It often occurs with pain syndrome due to the compression of nearby structures. Substituted hemangiomas are usually referred to as a capillary type. There may be a streaming breathing immediately at birth or shortly after it. Often laughing with leather.
. Treatment .. Congenital skin hemangioma. In the absence of rapid growth, the expectant tactic is shown ... when the child reaches school agePerhaps the removal of formations causing cosmetic defects ... In the treatment of skin lesions, the inconsistent results gives laser therapy, cryodestruction .. Subject lesions. Assign the GC, less frequently produce excision with a laser or tracheostomy .. during common lesions, an operation is necessary. Excellent results gives super-selective embolization of vessels feeding hemangiomes and subsequent ultra-high-frequency current therapy.

Cysts - hygromes behave like tumors. They are found in most cases on the neck, more often at birth or shortly after it.

. Anatomy. Favorite localization - a blatant - trapezoidal triangle of the neck .. on top they can reach the cheeks or the parotid area, and from the bottom - the mediastinum or the axillary region .. it is possible to distribute large formations for the sternum - clarity - the prevailing muscle on the front of the neck (up to the opposite direction ) .. It is possible to involve the bottom of the oral cavity and the root of the language.

. Clinical picture .. Difficulties in breastfeeding .. deformities of the face or neck .. respiratory disorders .. signs of compression shoulder plexus: pain and hyperesthesia .. Sometimes there is a sudden increase in the size of the cyst with spontaneous hemorrhage into it.
. Characteristic .. Hygromas can progress, remain unchanged or regressing .. Small lesions are single-chamber and dense .. large tumors are usually multi-chamber, movable, they can be survived .. The walls of the cyst are tense. Since the chambers tend to combine, the rupture of the wall of one of them leads to partial collaboration of the rest.

. Treatment - Surgical .. often there are relapses, since cysts are able to grow into adjacent fabrics, which makes it impossible to completely remove them. The larger the lymphhangomatous hygroma component is expressed, the greater the probability of recurrence.

MKB-10. D17.0 benign neoplasm of the adipose tissue of the skin and subcutaneous tissue of the head, face and neck. D21.0 benign neoplasm connecting and other soft tissues of head, face and neck. D18 hemangioma and lymphangioma of any localization. D21.0 benign neoplasm connecting and other soft tissues of head, face and neck.

RCRZ (Republican Center for Health Development MD RK)
Version: Clinical Protocols MH RK - 2017

Other refined cysts of the area of \u200b\u200bthe mouth, not classified in other categories (K09.8)

Maxillofacial Surgery

general information

Short description

Approved
Joint Commission for Medical Services
Ministry of Health of the Republic of Kazakhstan
from "29" June 2017
Protocol No. 24.

Dermoid cyst- a benign formation consisting of epidermis, dermis, hair follicles, sebaceous glands, developing in the field of embryonic gaps, grooves and ectoderm folds from dystopic elements of ectodermal tissue during the embryonic development period.

Input part

Code (s) μb-10:

MKB-10
The code	Name
K09.80	Dermoid cyst

Date of development / revision of the Protocol:2017 year.

Abbreviations used in the protocol:

v / B.	-	intravenously
v / M.	-	intramuscular
Act.	-	aspartataminotransferase
ALT.	-	alaninotransferase
HIV	-	aIDS virus
Kt.	-	cT scan
LFK	-	physiotherapy
MRI	-	magnetic resonance imaging
Oak	-	general blood analysis
OAM	-	general urine analysis
Soe	-	erythrocyte sedimentation rate
UD	-	level of evidence
Ultrasound	-	ultrasound procedure
ECG	-	electrocardiogram
ER.	-	erythrocytes
HB.	-	hemoglobin
HT	-	hematokritis
Le.	-	leukocytes
Tr	-	thrombocytes

Protocol users:maxillofacial surgeons, dentists, oncologists, pediatricians, ps, surgeons, therapists.

Scale level proven:

BUT	High-quality meta-analysis, systematic Overview of RCA or large RCCs with a very low probability (++) systematic error, the results of which can be distributed to the corresponding population.
IN	High-quality (++) systematic overview of cohort or studies Case-control or high-quality (++) cohort or studies Case control with a very low risk of a systematic error or RCK with not high (+) risk of systematic error, the results of which can be distributed to the appropriate Population.
FROM	Cohort or study case-control or controlled study without randomization with not high risk of systematic error (+), the results of which can be distributed to the corresponding population or rock with a very low or low risk of systematic error (++ or +), the results of which cannot Be directly distributed to the appropriate population.
D.	A description of a series of cases or an uncontrolled study, or the opinion of experts.
GPP.	Best clinical practice.

Classification

Classification :

Diagnostics

Methods, approaches and diagnostic procedures

Diagnostic criteria

Complaints and history of patients with dermoid cysts
Complaints:	Education		Cyst or fistula, as a rule of typical localization, in the neck area, the bottom of the oral cavity, submandibular, periorubital, parole, temporal area, area of \u200b\u200bthe nose and its wings.
	For deformation of the face		The severity of deformation depends on the time of the initial signs of deformation until the initial signs of deformation before the appeal.
	Functional disorders		Violation of the mobility of the language, swallowing, speech, when the cure large size is reached, localized at the bottom of the oral cavity.
	On pain		With the suppuration of the cyst, pain appears, an increase in body temperature
Anamnesis of the disease:	Rough cysts slowly, asymptomatic		Pathology is aged
	Duration of the disease		From several months to several years
	Gnove-inflammatory complications		May occur due to infection.
Anamnesis of life:	Transferred and related diseases		It is necessary to pay attention to the combination of neoplasm with defects
Physical examination
External inspection, palpation, oral cavity		The cyst is tested in the form of a tumor formation of a rounded shape, located in the thicker of soft tissues. Education consistency is elastic elastic or test, the surface is smooth, the boundaries are clear. When it is located closer to the surface of the skin (during localization in the periorubital region and the nose), dermoid cysts rarely reach large sizes, unlike dedicious cysts localized in the depths of soft tissues, which can reach large sizes (5-6 cm.). Dermoid cysts of the oral cavity are located between the inner chin (Spina Mentalis Interna) and the sub-bandy bone, along the midline over the maxillary-speaking muscle between the printent-language muscles. If the cyst is attached to the sub-band bone, it is manifested in the form of a semi-shaped protrusion in the pre-planning area. The cyst, associated with the pre-arms, grows towards the subwage region, lifting the front part of the language and the mucous membrane of the front department of the sub-surround region. When the large size of the cyst is shifted under the mucous membrane of the mouth of the mouth behind the front teeth. Cysts associated with the sub-band bone are shifted with it when swallowing. When the middle line is located, a dermoid cyst can spread to the front section of the submandibular triangle. On the neck, dermoid cysts are localized between the front edge of the breast-curable-bed-like muscle and the rear abdomen of the bubbly muscle. The cysts of the near-wing area lie deeply, causing a unauthorized outside the deformation of soft tissues.
Laboratory research:
Oak		- leukocytosis, acceleration of ESO;
Histological examination		In the study of the structure of the cyst and their contents, derivatives of ectoderma are detected - hair, saline and sweat glands. The shell is a dense fibrous connective tissue with a pronounced papilla layer, in which there are well-developed sewe of glands and hair onions. The inner surface of the shell is lined with a multilayer flat epithelium. When studying the cyst of the oral cavity, the puffy layer is not always well expressed, and skin derivatives are in the germinal state.
Tools:
Ultrasound		echonegative structure with clear contours, well visualized capsule
Kt.		rounded education, density corresponds to adipose tissue
MRI		benign cystic formation, rounded form. Thin reinforced wall. High signal intensity on T1-weighted image, high - on T2-weighted image

Indications for consultation of specialists:

· Consultation of anesthesiologist - for anesthetic manual;
· Consultation of an otorinolaryngologist - when germinating a tumor in the nasal cavity;
· Consultation of an ophthalmologist - when germinating a tumor in the cavity of the orphanage;
· Consultation of the therapist - in the presence of concomitant diseases;
· Consultation of other narrow specialists - according to the testimony.

Diagnostic algorithm:

Differential diagnosis

Differential diagnosis and substantiation of additional research.

Diagnosis	Justification for differential diagnosis	Surveys	Criteria for exclusion of diagnosis
Acute and aggravated chronic lymphadenitis	Similar clinical picture With the suppuration of the dermoid cyst. Often the dermoid cyst for the first time manifests clinically only after the suppuration	Puncture with microscopic research	With a microscopic study of the contents of dermoid cyst, there are broken epithelial cells, buried the structureless inclusions and cholesterol crystals.
Metastasis of malignant tumors	Metastasis B. the lymph nodes The top section of the neck, submandibular, pre-aromatic and parotic regions have similar clinical manifestations		Metastases are manifested in the form of dense, painful tumor-like formations that do not have clear boundaries and early losing mobility. With a morphological study, atypical cells are detected.
Tuberculosis and sarcoidosis.	The lesion of lymph nodes with tuberculosis and sarcoidosis is similar on a clinical picture with dermoid cysts of the neck and the submandibular region	Anamnese, clinical examination, biopsy	With tuberculosis and sarcoidosis of the clinic of the main disease, accompanied by damage to the lungs. In a morphological study, giant Pirogov-Langhans are found
Tumors of salivary glands	Dermoid cysts, localized near the parole salivary glands, as well as adenolymphomes, can resemble the contents of epidermoid cyst	Syalography	On the siarography, with tumors, structural changes in the salivary gland tissue, in the case of a puncture biopsy a piece of tumor tissue is obtained
Middle and side cysts	The similarity of the clinical course of the dermoid and side cyst of the neck, as well as the median cysts and dermoids of the pre-planning region.	Cystography	In contrast cystography, dermoid cysts, in contrast to the median, filled evenly and do not have lateral branches, as well as the fistulous move going towards the bottom of the oral cavity.
Ranula	Dermoid cysts of the mouth of the oral cavity, growing mainly towards the tongue, may have resemblance to wounds.	Inspection of the oral cavity	Dermoid cysts are located in the midline and shine under the mucous membrane of the sub-surround region in the form of a denselylastic semi-odd formation of yellowish color, while the wound has a soft fluttering formation

Treatment abroad

Treat treatment in Korea, Israel, Germany, USA

Get advice on medical examination

Treatment

Preparations (active substances) used in the treatment

Treatment (hospital)

Tactics treatment at the stationary level:
In the stationary level, surgical treatment under local / general anesthesia is carried out. After the intervention, antibacterial, nonsteroidal anti-inflammatory drugs are prescribed, and disinfecting therapy is carried out if necessary.

Not medicia treatment:
· Mode II;
· Diet: Table number 17 (diet therapy is appointed according to indications).

Surgical intervention:
· Cystectomy:
Indications for surgery:
· Large cyst size more than 5 cm;
· The growth and availability of cysts cause a function violation;
· Recurney after surgical treatment;
· Development of complications in the form of suppuration of cysts
Contraindications:
· Level-heart failure of III-IV degree;
· Blood coagulation disorders, other diseases of the circulatory system;
· Myocardial infarction (post-infarction period);
· Heavy forms of concomitant diseases (decompensated diabetes, aggravation of the ulcer of the stomach and duodenum, liver / renal failure, congenital and acquired heart defects with decompensation, alcoholism, etc.);
· Acute and chronic diseases of the liver and kidney with functional failure;
· infectious diseases In the stages of exacerbation.
Medical treatment:to relieve the symptoms of the suppuration of the dermoid cyst, as well as for symptomatic therapy in the postoperative period.

Medicia treatment

List of basic medicines:

№	Preparation, form of release	Motherwise dose	Multiplicity of administration	UD
	Opioid analgesics
1	tramadol. 100mg / 2ml 2 ml or 50 mg orally	Adults and children over the age of 12 are introduced / in (slowly drip), in / m at 50-100 mg (1-2 ml of solution). In the absence of a satisfactory effect after 30-60 minutes, an additional administration of 50 mg (1 ml) of the preparation is possible. The multiplicity of administration is 1-4 times a day depending on the severity of pain syndrome and the effectiveness of therapy. Maximum daily dose - 600 mg. Contraindicated children under 12 years old.	. In order to anestheticing in the postoperative period, 1-3 days	BUT
	Nonteroidal antiberial means
2.	ketoprofen. 100 mg / 2ml 2 ml or orally 150mg prolonged 100mg.	the daily dose at V / B is 200-300 mg (should not exceed 300 mg), further oral administration of prolonged 150 mg 1 p / d, 100 mg 2 p / d	. The duration of treatment with C / V should not exceed 48 hours; . The duration of general use should not exceed 5-7 days, with anti-inflammatory, antipyretic and painful goal.	B.
3.	ibuprofen 100 mg / 5 ml100ml or orally 200 mg; Inside 600 mg	For adults and children from 12 years old, ibuprofen is prescribed 200 mg 3-4 times a day. To achieve a rapid therapeutic effect in adult dose, it can be increased to 400 mg 3 times a day. Suspension, one-time dose is 5-10 mg / kg body weight of the child 3-4 times a day. The maximum daily dose should not exceed 30 mg per kg of the body weight of the child per day.	. no more than 3 days as an antipyretic agent; . no more than 5 days as an anesthetics With anti-inflammatory, antipyretic and painful goal.	A.
4.	acetaminophen200 mg or 500mg; For reception inside 120 mg / 5 ml or rectally 125 mg, 250 mg, 0.1 g	Adults and children over 12 years old with a body mass of more than 40 kg: one-time dose - 500 mg-1.0 g to 4 times a day. The maximum one-time dose is 1.0 g. The interval between receptions is at least 4 hours. Maximum daily dose - 4.0 g. Children from 6 to 12 years old: one-time dose - 250-500 mg at 250-500 mg to 3-4 times a day. The interval between receptions is at least 4 hours. Maximum daily dose - 1.5-2.0 g.	. Duration of treatment when applied as analgesic and as an antipyretic agent for no more than 3 days.	A.
	Hemostatic means
5.	ethailate 12.5% \u200b\u200b- 2 ml	4-6 ml of 12.5% \u200b\u200bsolution per day. Children are introduced once in / in or per / m at 0.5-2 ml, taking into account body weight (10-15 mg / kg).	. With the danger of postoperative bleeding introduced with a preventive purpose	B.

List of additional drugs:

№	Preparations		Motherwise dose		Multiplicity of administration	UD
	Antibacterial therapy
1	amoxiciline clavulanic acid(Preparation of choice)		V / in: Adults: 1.2 g every 6-8 h. Children: 40-60 mg / kg / day (by amoxicillin) in 3 administration.		. Course of treatment 7-10 days	A.
2	lincomycin (Alternative drug)		Apply in / m, in / in (drip only). It is impossible to enter into / in without prior dilution. Adults: 0.6-1.2 every 12 hours. Children: 10-20 mg / kg / day in 2 administration.		. Course of treatment 7-10 days	B.
3	ceftazidim (when highlighting P. Aeruginosa)		In / in and in / m: Adults: 3.0-6.0 g / day in 2-3 administration (with a bluegenic infection - 3 times a day). Children: 30-100 mg / kg / day in 2-3 administration;		. Course of treatment 7-10 days	A. [ 24-26]
4	ciprofloxacin (when highlighting P.aeruginosa)		In / in: Adults: 0.4-0.6 g every 12 hours. Introduced by slow infusion for 1 hour. Children are contraindicated.		. Course of treatment 7-10 days	B.
	Desensitizing therapy
5	clemastine	Adults and children from 12 years and older: 1 mg. Children from 6 to 12 years: 0.5-1mg		. Adults and children from 12 years old and older: twice a day, in the morning and evening. Children from 6 to 12 years before breakfast and at night.		IN
6	chloropyramine	Inside, adults: 25 mg, if necessary, increase to 100 mg. Children from 1 to 6 years old: 6.25 mg or 12.5 mg from 6 to 14 years old: 12.5 mg		. Inside, adults: 25 mg 3-4 times a day, if necessary, increase to 100 mg; . Children from 1 to 6 years old: 6.25 mg 3 times a day or 12.5 mg 2 times a day from 6 to 14 years old: 12.5 mg 2-3 times a day.		FROM

Further postoperative management:
· Observation from the maxillofacial surgeon - 2 times a year;
· Oncologist doctor - by testimony.
· Restoration of the function and anatomical shape of the tissue of the maxillofacial region and neck with the help of primary (or delayed) skin plastics.

Indicators of the effectiveness of treatment:
· Removal of cysts;
· Restoration of damaged anatomical structures;
· Restoration of broken functions.

Hospitalization

Indications for hospitalization indicating the type of hospitalization

Indications for planned hospitalization:
. Dermoid cysts of the face and neck.

Indications for emergency hospitalization :
. The suppuration of the dermoid cysts of the face and neck, asphyxia against the background of large sizes of cysts.

Information

Sources and literature

Meeting Protocols of the Joint Commission on the Quality of Medical Services MD RK, 2017
1. 1) Sergienko V.I, Kulakov A.A, Petrosyan AD. and etc. Plastic surgery Faces and Neck, Gootar Media 2010. - 328 p. 2) Zelensky V.A., Mukhoramov F.S., Children's Surgical Dentistry and Maxillofacial Surgery: Tutorial. - M.: Gootar Media, 2009. - 216C; 3) Afanasyev V.V. Surgical dentistry - M., Gootar Media., 2011, -c.468-479; 4) Kozlova V.A., Kagan I.I. Operational Maxillofacial Surgery and Dentistry, Gootar Media 2014. - 544 p. 5) Kulakov A.A. Surgical dentistry and maxillofacial surgery. National Guide / Ed. A.A. Kulakova, T.G. Robustova, A.I. Narobeeva. - M.: Goeotar Media, 2010. - 928 C; 6) Parechy A.I. Tumoli heads and necks. Fifth edition recycled, 2013. - 480 p. 7) Fishchev S.B. Inflammatory diseases , injuries and tumors of maxillofacial specialties, 2015. - 198 p. 8) Linkov G, Kanev P.M, Isaacson G. Conservative Management of Typical Pediatric Postauricular Dermoid Cysts. Int j PediaTr Otorhinolaryngol. 2015 nov; 79 (11): 1810-3. DOI: 10.1016 / J.IJPORL.2015.08.006. EPUB 2015 Aug 13. Review 9) Shakeel M, Keh SM, Chapman A, Hussain A. Intra-Parotid Dermoid CYST: Excision Through A Face Lift Incision. J Coll Physicians Surg Pak. 2014 NOV; 24 Suppl 3: S238-9. DOI: 11.2014 / jcpsp.s238s239. Case Report 10) Reissis D, PFAFF M.J, Patel A, Steinbacher D.M. CRANIOFACIAL DERMOID CYSTS: Histological Analysis and Inter-Site Comparison. Yale J Biol Med. 2014 SEP 3; 87 (3): 349-57. ECOLLECTION 2014 SEP. COM Study 11) Kolomvos N, Theologie-Lygidakis N, Tzerbos F, Pavli M, Leventis M, Iatrou I. Surgical Treatment of Oral and Facial Soft Tissue Cystic Lesions in Children. A RETROSpective Analysis of 60 Consecutive Cases With Literature Review. . J CranioMaxillofac Surg. 2014 Jul; 42 (5): 392-6. DOI: 10.1016 / J.JCMS.2014.01.023. EPUB 2014 Jan 18. 12) LENCI LT, SHAMS P, SHRIVER E.M, ALLEN R.C. Dermoid CYSTS: Clinical Predictors of Complex Lesions and Surgical Complications. J Aapos. 2017 Feb; 21 (1): 44-47. DOI: 10.1016 / J.jaapos.2016.09.023. EPUB 2017 Jan 9. 13) Berbel P, Ostrosky A, Tosti F.Large Sublingual Dermoid CYST: A Case of MandiBular Prognathism. CranioMaxillofac Trauma Reconstr. 2016 NOV; 9 (4): 345-348. EPUB 2016 Apr 21. 14) Sahoo N.k, Choudhary A.K, Srinivas V, Kapil Tomar. DERMOID CYSTS OF MAXILLOFACIAL REGION. MED J Armed Forces India. 2015 DEC; 71 (Suppl 2): \u200b\u200bS389-94. DOI: 10.1016 / J.MJAFI.2013.11.004. EPUB 2014 Mar 6. 15) Dillon J.R, Avillo A, Nelson B.L.Dermoid Cyst of The Floor of the Mouth. Head Neck Pathol. 2015 SEP; 9 (3): 376-8. DOI: 10.1007 / S12105-014-0576-Y. EPUB 2014 Oct 29. 16) Wagner M.W, Hailselassie B, Kannan S, Chen C, Poretti A, Tunkel D.E, Huisman T.A. Oropharyngeal Dermoid CYST IN AN INFANT WITH INTERMITENTENT Airway Observation. A Case Report. NEURORADIOL J. 2014 Oct; 27 (5): 627-31. DOI: 10.15274 / NRJ-2014-10085. Epub 2014 Sep 25. 17) Dutta M, Saha J, Biswas G, Chattopadhyay S, Sen I, Sinha R. Epidermoid Cysts in Head and Neck: Our Experiences, With Review of Literature. Indian J Otolaryngol Head Neck Surg. 2013 Jul; 65 (Suppl 1): 14-21. DOI: 10.1007 / S12070-011-0363-Y. EPUB 2011 DEC 4. 18) Jeremy D. Meier, MD, and Johannes Fredrik Grimmer, MD Evaluation and Management of Neck Massees In Children University Of Utah School of Medicine, Salt Lake City, Utah Am Fam Physician. 2014 Mar 1; 89 (5): 353-358. 19) robert a schwartz, md, mph; Chief Editor: Dirk M Elston, MD. Dermoid CYST Treatment & Management May 04, 2017 20) Lockhart PB, Loven B, Brennan MT, Baddoor LM, Levinson M. The Evidence Base for the Efficiency of AntiBiotic Prophylaxis in Dental Practice. J am Dent Assoc 2007; 138 (4): 458-74. 21) Lockhart, PB, Hanson, NB, Ristic, H, Menezes, Ar, Baddoor, L. Acceptance Among and Impact on Dental Practitioners and Patients of American Heart Association Recommendations for AntiBiotic Prophylaxis. J Am Dent Assoc 2013; 144 (9): 1030-5 22) Impact of Antibiotic Stewardship On Perioperative AntimiCrobial Prophylaxis.murri R1, De Belvis Ag2, Fantoni M1, Tanzariello M2, Parente P3, Marventano S4, Bucci S2, Giovannenze F1, Ricciardi W2, Cauda R1, Sganga G; COLLABORATIVE SPES GROUP 23). MERTEN HA1, Halling F. INT J Qual Health Care. 2016 Jun 9. 24) Clin Ther. 2016 Mar; 38 (3): 431-44. DOI: 10.1016 / J.ClinThera 2016.01.018. EPUB 2016 Mar 2.Ceftazidime-Avibactam: A Novel Cephalosporin / β-Lactamase Inhibitor Combination For the Treatment of Resistant Gram-Negative Organism. Sharma R1, Eun Park T2, Moy S3.

Information

Organizational aspects of the Protocol

List of protocol developers:
1) Batyrov Tuleubai Uralbayevich - the main freelance maxillofacial surgeon of the Ministry of Health of the Republic of Kazakhstan, the doctor of the Maxillofacial Surgeon, Professor, Candidate of Medical Sciences, Head of the Department of Dentistry and Maxillofacial Surgery, JSC Medical University Astana.
2) Sagyndyk Hassan Lukotovich - doctor of the maxillofacial surgeon, candidate of medical sciences, professor at the Department of Dentistry and Maxillofacial Surgery, JSC "Medical University Astana".
3) Utepov Dilshat Karimovich - the doctor of the maxillofacial surgeon, the UK "Aksai" by the KazNMU. S.D. Asphenedia, assistant Department of Dentistry of Children's Age KazNMU. S.D. Asphendiyarova.
4) Sadvakasova Lyazzat Mendibaevna - Ph.D., maxillofacial surgeon, associate professor of the department of dental disciplines, RGP on PVV "GMU G. Family" MZSR RK.
5) Sugurbaev Adil Asylkhanovich - doctor of the maxillofacial surgeon, undergraduate Department of Dentistry and Maxillofacial Surgery, JSC "Astana Medical University".
6) Ihambaeva Ainur Vigymanovna - Assistant of the Department of General and clinical pharmacology, JSC "Astana Medical University, Clinical Pharmacorog".

Indication for the absence of conflict of interest:not.

Reviews list:
Nurmaganov Serik Baltashevich - doctor of a maxillofacial surgeon of the Higher Category, Doctor of Medical Sciences, Professor of the Department of Dentistry of Children's Age KazNMU. S.D. Asphendiyarova, Head of the Department of Children's Maxillofacial Surgery GKB No. 5 of Almaty.

Note Protocol Review Conditions: Revision of the Protocol 5 years after its publication and from the date of its entry into force or in the presence of new methods with the level of evidence.

Attached files

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own sinks are innate
shaino-ear

Preda compensive sinus and cyst

Glaba Greet Development Anomaly

Hypertrophy lips in the birth

Medial:

face and Neck Cyst
fistula Faces and Neck
sinus face and neck

Congenital Anomaly of Face and Neck BDU

In Russia, the International Classification of Diseases of the 10th Review (ICD-10) adopted as a single regulatory document To take into account the incidence, the reasons for the appeals of the population into medical institutions of all departments, the causes of death.

The ICD-10 has been introduced into the practice of health throughout the territory of the Russian Federation in 1999 by order of the Ministry of Health of Russia from 27.05.97. №170

A new revision (ICD-11) is planned to be planned in 2017 2018.

With changes and additions to WHO.

Processing and transferring changes © MKB-10.com

Neck cyst: symptoms and treatment

Neck cyst - main symptoms:

Weakness
Dizziness
Nausea
Vomot
Subfebrile temperature
Intoxication
Lethargy
Figure Mouth
Sweeping in the affected place
Deterioration of general condition
Cryer on the neck

Etiology

Classification

side or branchogenic;

venous hemangioma;
fat tumors.

Symptomatics

weakness, lethargy;

increased body temperature;
weakness, dizziness;

Diagnostics

blood test to oncomarkers;
Uzi Neck;
fistulography;
CT if necessary.

Treatment

Prevention

Neck cyst - symptoms and treatment

Weakness
Nausea
Dizziness
Vomot
Intoxication
Subfebrile temperature
Lethargy
Redness of the skin in place of defeat
Increased temperature in the affected area
Figure Mouth
Deterioration of general condition
Sweeping in the affected place
Pain when pressing for neoplasm
Cryer on the neck
The impossibility of full flexion of the neck
Child can't keep his head

The neck cyst is a tumor formation of a hollow type, which is located on the side or front surface of the neck, most often in innocent nature, however, it may be a consequence of a congenital neck fistula. Side cysts are a consequence of congenital pathology for the development of the fetus, while the middle cyst of the neck of the child is diagnosed between the ages of 4 and 7 years, it can often flow asymptomatic. In half cases, the neoplasm is applied, which leads to emptying of the glance and the formation of a fistula.

Treatment only surgical. Puncture is used extremely rare, since the accumulation of the liquid or porridge mass after a while is repeated. According to the international classification of disease, this pathological process refers to other innate anomalies of the face and neck. Code on MKB-10 - Q18.

Causes of disease

A side or branchogenic ebony cyst, in most cases, is a congenital pathology and is diagnosed at birth. This is due to the improper development of gill cracks and arcs, the formation of a gender formation occurs on the 4-6 week of pregnancy.

It should be noted that the side cyst of the neck is more dangerous than the median form, since in most cases, subject to the lack of timely treatment, is reborn into malignant education. Also, during growth, such a form of the neck of the neck can squeeze the nerve endings and nearby organs, which can lead to concomitant pathological processes. Just like other forms of hollow tumor formations, it can be spontaneously opened and leads to non-healing gill fistulas.

The median cyst in adults (thyreogolosal) may be a consequence of such etiological factors:

In 60% of cases, the median echo cyst is caught up, which can cause violations of the swallowing function and speech. In some cases, such a neoplasm is spontaneously revealed, which leads to the formation of a fistula.

The exact causes of the development of the pathology of the gill slit and arc during the development of the fetus are not established. However, clinicians allocate such possible predisposing factors:

genetic predisposition - if a history of parents or one of them has such a pathological process, such a clinical manifestation may be observed in a newborn;
strong stress, constant nervous voltage of the mother during the nipping of the child;
abuse of alcohol and smoking;
treatment with "heavy" drugs during pregnancy, especially in early time. It should include antibiotics, anti-inflammatory, painkillers, corticosteroids;
systemic diseases in mothers;
the presence of chronic diseases.

In the presence of such a symptom, the child should immediately access the doctor. Ignore such a clinical manifestation is extremely dangerous, since the likelihood of rebirth is great malignant tumor.

Classification of disease

Severe two main types of neoplasms on the neck:

side or branchogenic;
middle or thyrectural.

Side cysts, in turn, are divided into:

Localization of cyst and fistula neck

According to the structure and principle of education, such forms of neoplasms are distinguished:

the dermoid cyst of the neck - refers to congenital pathologies, lies on the surface, is not attached to the throat. As a rule, such a neoplary is filled with the cells of the sebaceous and sweat glands, the hair follicle;
zhabelnaya - located in the area of \u200b\u200bthe bone under the tongue, consists of the epithelium pants of the gills.

The following classification of the neck cyst can also be used, according to the nature of education and localization:

the hygroma is a soft and smooth education, which is located in the lower cervical department;
venous hemangioma;
primary lymphoma - a group of soldered compacted knots;
neurofibrome - fixed, dense consistency in education, diameter from 1 to 4 centimeters;
the thyroid-tongue - can be localized in the area of \u200b\u200bthe larynx and neck, moves up or down in the process of swallowing;
fat tumors.

Regardless of which ethiology in the neoplasm, it is subject to surgical removal, since the risk of transition to a malignant form is almost always.

Symptoms of Disease

Some forms of neoplasm on the neck in children or adult for a long time may proceed asymptomatic. As the height of the tumor is growing, such symptoms may be present:

the impossibility of complete flexion of the neck;
at the palpation of the neoplasm, pain feels;
tumor movable, skin covers are unchanged, but it is possible to redness;
the child can not hold his head;
weakness, lethargy;
subfebrile body temperature, also possible local temperature increase;
signs of general intoxication of the body - nausea, vomiting, general ailment.

If the compensation process began, such symptoms of the clinical picture may be present:

local redness of the skin, humanity;
increased body temperature;
weakness, dizziness;
severe pain in palpation;
purulent exudate follows out, less often in the oral cavity;
the skin around the mouth can be covered with crusts.

In the presence of such clinical signs, immediately apply for medical attention. The purulent process can lead to abscess, phlegmon and other diseases, life-threatening.

Symptoms of a cyst of the neck

It should be understood that the output of the purulent exudate cannot be regarded as recovery and eliminating the need to appeal to the doctor. Educated fistula never heals independently, and the accumulation of fluid in the tumor almost always occurs repeated after a while. In addition, the risk of malignization is significantly increasing.

Diagnostics

First of all, a physical examination of a patient with a palpation of cysts on the neck is carried out. Also during the primary survey, the doctor must collect personal and family history.

To clarify the diagnosis, such laboratory and instrumental research methods can be carried out:

puncture of fluid from hollow education for subsequent histological research;
blood test to oncomarkers;
Uzi Neck;
fistulography;
CT if necessary.

General clinical researches Blood and urine, in this case, do not represent diagnostic value, therefore are carried out only if necessary.

Treatment of disease

In this case, the treatment is only operational, conservative techniques are not effective. The puncture is used only in the most extreme cases when the operation does not seem to be possible on medical records. Most often it concerns the elderly. In this case, a tumor content is aspiration, followed by washing with antiseptic solutions.

As for the traditional removal of the neck cyst, this operation is carried out under anesthesia, excision can be carried out both through the mouth and external, depending on clinical indicators. To prevent recurrence, excision is carried out with a capsule.

The removal of lateral tumors is more difficult, since the neoplasm is localized near the vessels and nerve endings.

If the patient has already entered the purulent process and education, then opening and draining the tumor is performed, followed by the removal of fistula. All fistulas are subject to excision, even thin and low-wing, as they can cause relapse. To clarify their localization, the surgeon can pre-introduce a staining drug (methylene blue, diamond greens).

After operation, the patient is prescribed anti-inflammatory and antibacterial therapy. Also, regular dressings should be carried out with the mandatory treatment of the oral cavity by antiseptic substances.

In the postoperative period, the patient should be observed a diet that implies the following:

from the diet for the period of treatment, it is necessary to exclude acid, sharp and too salty, coarse food;
drinks and dishes need to be used only for warm;
the dishes should be liquid or mashed.

If the surgical intervention is carried out in a timely manner, the risk of recurrence or development of the oncological process is practically absent. Long rehabilitation is not required.

Prevention

Unfortunately, in this case there is no effective methods Prevention. It is strongly recommended not to engage in self-medication and in a timely manner to see a qualified physician. In this case, the risk of developing complications is minimal.

If you think that you have a neck cyst and symptoms characteristic of this disease, you can help doctors: surgeon, therapist, pediatrician.

We also offer to take advantage of our services to diagnose diseases online, which, based on the entered symptoms, selects the likely diseases.

Congenital malforms of the development of the face and neck

RCRZ (Republican Center for Health Development MD RK)

Version: Archive - Clinical Protocols MH RK (Order No. 239)

general information

Short description

System disorders within the first and second boundaries gwee Doug. In the period of the embryonic development of the child. Common for all syndromes - dysplasia and (or) underdevelopment of tissues and organs of the person, entailing functional and aesthetic disorders.

Protocol "Congenital defects of the development of the face and neck"

Q 18.1 - Congenital preurb of cyst and fistula

Q 18.4 - Macrotomy

Q 18.5 - microstomy

Q 18.6 - Macrohelia

Q 18.7 - Maikrohelia

Q18.8 - Other refined faces of the development of the face and neck

Q 38.2 - Macrogness

Q 38.3 - Other congenital anamalia language

Q 16.0-Q16.1 - congenital anomaly and atresia audit

Q 17.0 - Additional Own Sink

Q 17.1-Q 17.3 - Macrotia, Microaty and Other Ear Anomalies

Q 17.5 - protruding ears

Classification

Classification of congenital faces and neck (WHO, 1975)

Congenital faces of the development of the face:

Cleft lips;

Through clefts of the upper lip and sky;

Oblique clefts (coloboma);

Cross clefts (macrostomy);

Fistulas of the lower lip;

Hypertelorism (median nose cleft), etc.

Congenital malformations of the cultivation of the oral cavity and pharynx:

Short bridle of the language;

Dental defects;

Small spectrum of the oral cavity;

Congenital villocks own sinks:

Dysplasia of abnormal sinks (microchips and anatics), the atresia of the auditory pass;

Old volumen fistulas (pre-fistulas and cysts);

Anomalies of 1 and 2 gill arcs, etc.

Congenital vices of the neck of the neck:

Middle and side fistula and neck cysts, etc.

Diagnostics

Complaints: on a cosmetic defect, violation of the anatomical functional integrity of the maxillofacial region (depends on the type of malformance).

The slashing of the face or koloboma is a severe congenital pathology resulting from the inconcement (complete or incomplete) of the nobbin and maxillary bugges during the embryonic development of the child. Clevering can be complete and incomplete, single and bilateral. More often there are incomplete oblique clefts.

Clinically cleft begins from the upper lip (right or left of the filter) and then continues towards the lower century and the upper appliance edge of the orbit. If the cleft is incomplete, then there is a cracking of the tissues of only the upper lip, and then, in the course of the cleft, the underdevelopment of soft and solid fabrics of the face is determined in the form of a rotten groove from the upper lip to the lower elegal orbit edge. As a rule, these children have underdevelopment or colobum of the eyelids and as a result of this - false exophthalm. The slashing of the face is often combined with another pathology of the face: the debris of the sky, hypertelectorism, anomaly of the oars and others.

Treatment of this pathology surgical, and it is carried out in different age periods Depending on the complete symptom complex of the disease (plastic of the upper lip, plastic of the eyelids, contour plastic facial, otoplasty, etc.).

The transverse cleft face or macrotom is one and a bilateral. It is the result of the incompleteness of the maxillary and the mandibular bugs during the embryonic development of the child. Clinically pathology is manifested in the form of a macroity of varying severity. At the same time, the cleft starts from the angle of the mouth and continues further towards the urine of the ear. Macrotom can be both isolated defects, as well as the symptom of some congenital syndromes. For example, when the Goldenhara syndrome, besides the macrostoms on the side of the lesion, there are underdevelopment of the lower jaw, the dysplasia of the auricle, the skin-cartilaginous predic acids, an epibulbar dermoid, etc., with the syndrome of the 1st Zhaba arc, Macrotomy is also often observed (G.V. Krichinsky, 1974).

Treatment of macroity surgical - reducing the oral gap to normal sizes. The lateral border of the oral gap is normally located on the pupil line. If you have ear pickups, they should also be deleted. Operational intervention is most suitable at the age of 2-3 years.

The median cleft of the nose (hypertelectlorism) is formed as a result of a violation of the fusion of the nasal plate of the nose-born forest during the period of embryonic development of the child. Clinically pathology is manifested in the form of splitting the tip of the nose and a small groove, going up the back of the nose, due to the discrepancy of the wicker cartilage. The nose tip is wide, flat, the nose partition is shortened. Sometimes hidden cleft spreads above the nose bone and even forehead. The bridges in these patients are wide, flattened, and through the skin can be placed bone crewing. Elets in these patients are widely (hypertelorism). All patients have typical wedge-shaped hair growing in the middle line of forehead. The median clefts of the nose can be combined with the anomalies of the teeth on the upper jaw, the elbow of the upper lip, congenital fistulas of the lips and other congenital pathology.

Treatment of median splashing nose surgical, depending on the severity of pathology. In easy cases, plastic wipers and the tip of the nose can be carried out. This operation can be carried out in more early age (13-15 years). In more severe cases, complete (including bone) rhinoplasty, which is carried out, as a rule, after 17 years. In addition, with pronounced hypertelectricism in adults it is possible to carry out a reconstructive operation on the frontal bone, the upper jaw, the zilly bones in order to normalize the face form. These rare and complex operations are carried out in some major clinics in maxillofacial surgery.

Syndrome 1 and 2 gill arcs. For patients with this pathology, a pronounced asymmetry of the person (single or bilateral) is characterized due to the underdevelopment of tissues forming from the 1-2th gill arcs in the process of embryonic development. The transfer of this syndrome by inheritance is observed in exceptionally rare cases. Most often occurs unilateral syndrome. At the same time, it is clinically determined by one-sided underdevelopment of the lower and the upper jaws, the zhilanny bone and the ear shell. All soft tissues of the lower and middle third of the face on the side of the lesion are also underdeveloped.

The underdevelopment of the lower jaw is especially pronounced in the field of jaw branches, coronary and microchlook. The branch of the jaw is underdeveloped, shortened, thinned. The corpuscles and the mysterious processes are also underdeveloped, and often missing at all. In these cases, as a rule, the bone elements of the temporomandibular joint (articular tubercle, the articular fox, etc.) are underdeveloped or are not defined. In severe cases, radiologically determines the underdevelopment of the body of the lower jaw on the "patient" side. In the aggregate, it leads to the fact that the chin is shifted to the "patient" side.

The underdevelopment (narrowing and shortening) of the upper jaw, as well as the ziculous bone leads to the compassion of the middle department of the face on the side of the defeat. In the oral cavity there is an oblique or cross bite, anomalies from the teeth. On the side of the damage, the underdevelopment of the muscles of the language and the soft sky is determined.

The syndrome of the 1-2-haired arc is always accompanied by an anomaly of the ear shell of varying degrees of gravity: from underdevelopment of her (microchitation) to a complete aplasia of the ear shell, when only the ear of the ear or a small skin and cartilage roller is preserved instead. These patients are narrowed or an outer hearing aisle is infected, near-dry skin-cartilaginous appendages, near-dry fistulas, etc. can be detected.

Treatment of patients with syndrome 1-2 of gill arcs long, multi-stage, complex (surgical-orthodontic) and very complex, aimed at restoring the shape and sizes of jaws, ear shell, etc., as well as the restoration of functions disturbed by the disease (chewing, hearing). In early childhood, starting with dairy bite and further until the end of the growth of the facial skeleton bones, orthodontic treatment is carried out. Starting from 8-9 years of age, it is possible to carry out otoplastics. Starting the silence is possible to carry out bone-plastic operations on the jaws. Nevertheless, the outcome of the treatment is not always consolation.

Pierre-Robin syndrome. Clinically pathology is manifested in the form of the triad symptoms: the sky is cleaned over the midline, microgenation or underdevelopment of the lower jaw and glossoptosis. All the symptoms are detected immediately after the child's birth. The degree of severity of these symptoms may be different: from easy to severe. The newborn is possible the development of dislocation asphyxia when the child is positioned on the back. This is the most severe functional impairment can lead to the death of a child. Cyanosis and asphyxia attacks are also characteristic during child feeding. Usually these children have a tendency to vomiting. Due to the foregoing and aspiration pneumonia, dystrophy and high lethaliness are often observed.

The treatment is to prevent asphyxia and aspiration of food from the first days of the child's life. For this language or lower jaw Fixed in the shut-out position with surgical or orthodontic methods. In some cases, it is enough to keep and hugging newborns on the stomach. Over time, the position of the lower jaw is stabilized by strengthening the muscles nominating the lower jaw. In the future, the rehabilitation of these children requires mogymnastics, orthodontic treatment and sky plastic in generally accepted terms.

Wanderwood syndrome is congenital symmetrical fists of the mucous gland glad of the lower lip in combination with the congenital clefts of the upper lip and the sky. Treatment is the plastic of the upper lip and the sky at normal time. Additionally, the operation of excision of congenital fistulas of the lower lip is required, which is advisable in preschool age.

Frankhety-colline syndrome or maxillofacial dysostics. The disease often has a family (hereditary) character. The characteristic symptoms of it is, unreserved the underdevelopment of the zick bones, the upper and lower jaws, the oars. For syndrome F.K. Characterized by the anti-monogoloid direction of the eye cracks: the eye slots are directed to each other at an angle due to the omission of the outer corners of the eyes (the eyes "house"). Often there is a colobome or underdevelopment of the eyelid. Underdevelopment of the upper jaw is accompanied by underdevelopment topper sinus, Anomalies of teeth and bite. Ear shells are underdeveloped in varying degrees. In aplasia of the auricles, there is an atres of external hearing aisters with partial or complete deafness. Macrottoma, ear appendages are possible. Sometimes there are additionally found the middle cleft of the sky, cleaned upper lips.

Treatment of patients with this pathology Long, phased and combined (orthodontic and surgical). It is carried out according to aesthetic and functional indications in various age periods, depending on the severity of the existing symptoms.

Card-facial dysostics (C-M Crowzon). In the development of the disease, the hereditary factor plays a significant role. The brain skull is almost normal or slightly reduced and deformed. The seams are obliged, in advance. The base of the skull is shortened. There is a sharp underdevelopment of the upper jaw, and eyeballs, zick bones. As a result, the false exophthalm is determined, and the eyes are filled forward and to the parties, i.e. Dissate. Because of the sharp underdevelopment of the upper jaw, crowded, retention, dystopia and other pathology from the teeth and the dental row of the upper jaw are detected, as well as false progress. Sometimes there are anomalies of the internal and middle ear.

The treatment of Crowzon's syndrome is most often palliative, symptomatic, aimed at eliminating certain symptoms of the disease (normalization of the position of teeth or bite, contour plastic facial, etc.). Radical reconstructive surgical interventions on the bones of the facial and brain skeleton are carried out only in some major maxillofacial clinics of the world.

Card-cranial dysostics. The disease may have inheritance. Clinically characterized by an increase in cerebral and decrease in the face of the skull. The patient's forehead is big and wide, and the face is small. The bones of the middle department, especially the upper jaw, are underdeveloped. Since the lower jaw has normal sizes, a false progress is formed. For pathology, multiple defects of the development of constant teeth (adenctia, retention, etc.) are characterized. In addition, patients have underdevelopment or aplasia of the clavicle. In this regard, the shoulder belt has pathological mobility - the patient can bring together both shoulder ahead.

Treatment of these patients in practice is most often palliative - elimination of teeth anomalies, bite or contour plastic facial. Reconstructive bone operations are rare.

Laboratory studies are not changed. Possible: hypochromic anemia, hypoproteinemia, which is associated with power disorders.

X-ray painting: depends on the type of malformation.

Indications for consultation of specialists - in the presence of concomitant pathology:

Otoidolaryngologist - the presence of an anatomical defect leads to pathological changes in the cavity of the nose and nasopharynx and leads to such diseases as: chronic rinopharygitis, hypertrophy of nasal shells, tonsillites, tobobotites, etc.;

Consultation of the dentist, the gynecologist for the sanitation of the oral cavity infection and external genital organs;

Allergist in manifestations of allergies;

Violations by ECG and others. Are an indication for consulting a cardiologist;

In the presence of viral hepatitis, zoonous and intrauterine and other infections - infectious diseases.

Differential diagnosis: no.

List of major diagnostic activities:

1. Common blood test (6 parameters).

2. Common urine analysis.

3. Biochemical blood test.

4. Study Cala on Eggs Hist.

5. Determining the time of coagulation of capillary blood.

6. Definition of blood type and factor rhesus.

7. Consultation of a doctor of anesthesiologist.

List of additional diagnostic events:

1. Computer tomography head and neck.

2. Panoramic X-ray of jaws.

3. Ultrasound of the abdominal organs.

5. X-ray of jaw bones in two projections.

Neck cyst - Major varieties and treatment

The neck cyst is a benign neoplasm, the cavity of which is filled with liquid, hair follicles, connective tissue. In accordance with the International Classification of the ICD-10, the median cilaty neck is included in the Q10-Q18 block. In most cases, it is localized from the front or side (the side is diagnosed in 60% of cases), less often - on the neck from behind in the spine zone. Pathology is rarely accompanied by uncomfortable sensations, there is no pain syndrome, the cyst does not affect the usual way of life, you can live with it without problems up to old age. Sometimes there is a threat to transform such a tumor into malignant, in such cases requires urgent removal.

Pathology is rarely diagnosed, occurs in 2-5% of all maxillofacial zone tumors and cervical department.

Development mechanism

The cyst on soft tissues is formed due to pathological processes occurring at the embryonic development phase, most often the neoplasm is diagnosed during the first year after the birth of the baby. When localizing in front, a congenital cyst for a long time can remain invisible and detected in adolescence.

Most often, the cyst is not dangerous, but some varieties, cystic hygroma in particular, becomes the cause of the child's intrauterine death.

Classification

There are several groups of classifications on the structure of the tumor and the location of localization (in front, on the side, rear).

Varieties by nature of education:

brangiogenic cyst (gill) - is formed due to pathologies of the development of the embryo, in the course of its growth, the unrelated gill pockets are filled with liquid;
the dermoid cyst of the neck is filled with the cells of the coarse and sweat glands, connective tissue;
lymphogenic - arises as a result of lymph dysfunctions, filled with serous fluid;
cystic - distributed among children, in 90% of cases require surgery;
epidermal - is formed due to clogging of the sebaceous gland epidermal cells, occurs near the spine on the hair growth line.
the median cyst develops as a result of injuries, infections, blood diseases and lymphs, in 50% of cases, pathology is accompanied by the suppuration, the formation of fistulas that open into the oral cavity or outwards; Through the fistula, purulent fluid comes out, its penetration into the body can cause strong intoxication.

Symptoms

The neoplasms are less than 1 cm visually invisible, only a professional doctor can establish its presence.

Symptoms are somewhat different depending on the type of neoplasm, it is defined as an elastic tumor, painless when pressing. In lateral cyst, signs can be confused with other pathologies of the cervical department, most often a benign neoplasm is manifested after mechanical damage or bacterial / viral infection.

As a result, the following symptoms arise:

tissue swelling, swallowing pain;
mobility of the neoplasm;
inflammation of lymph nodes;
large deformation;
abscess - after filling in gently and inflammation, abscess or sepsis develops, which leads to infection of blood, inflammation of tissues, necrosis and infection of the whole organism.

Diagnostics

Symptoms are often hidden, only a planned medical examination helps to identify the disease. When diagnosing benign swollen, the capsule on carcinomas is inspected, their presence is considered a hazardous complication of the disease.

study of the patient's condition, checking cases of cancer among relatives;
primary palpation of the affected area;
tomography and histological examination;
puncture, microbiological research of cells filling the neoplasm.

Treatment

The only way to treat cyst is considered surgical removal, drug therapy is ineffective. In children, the operation is carried out after the achievement of a three-year-old age - in adults after identifying pathological symptoms. The removal method is chosen after a thorough study of the neoplasm, the establishment of its species, sizes and other individual characteristics. The duration of the operation does not exceed the hour, it is required to carry out general anesthesia. Intervention requires professionalism and attention, incomplete removal threatens recurrence, the operation is carried out in the outpatient conditions, there is no need for hospitalization.

Cystous formations are characterized by sensitivity to any thermal procedures, therefore, self-medication in this case is strictly contraindicated, compresses and rods can cause damage organis.

Indications for surgery:

excess the size of a tumor 1 cm;
pain;
difficulties when swallowing and pronouncing phrases.

Features of the operation:

Officially plays an important role, with serious diseases and old age, the operation is contraindicated. Instead, the content of the neoplasm is removed, after which the cavity is purified by antiseptic means.
The aggravation of the inflammatory process - the cavity is revealed, drainage is carried out, the mine is removed, the operation is carried out after 2-3 weeks of anti-inflammatory therapy, the capsule is re-washed. Sometimes there is no need for operational intervention, since the cavity is headlong in itself.
The removal of small cyst can be carried out through the oral cavity, such a method avoids the formation of seams.
Large tumors are removed through skin cuts, special caution is required when removing side neoplasms, as they affect the nerves.
The median cyst is connected to the sub-bandy bone, so the tumor is removed together with its part.
The operation is complicated by the presence of fistula, to identify all the subtle yields of which the contrast agent helps. In the lateralization of the cyst, the situation is dried by the presence of large blood vessels.

After the operation, the doctor prescribes antibiotic therapy and the reception of anti-inflammatory funds, physiotherapy is shown as additional treatment. Removing seams is carried out a week after the operation.

The probability of recurrence increases with diagnosed lymphadenitis, to avoid re-education of cysts will help the course of special rinsing, sharp and coarse dishes should be excluded from the diet.

Prevention

The neck cyst is a congenital disease, therefore prevention measures are often absent, the passage of regular preventive inspections will help prevent suppuration. An experienced doctor diagnoses the cyst at an early stage of development, after which the operation is carried out.

Forecast

Since the only method of treatment is operational intervention, there is a risk of complications. In 95% of cases, intervention ends successfully, the forecast depends on the rehabilitation period, the danger can represent the malignant foci discovered during the operation.

Conclusion

The neck of the neck is a congenital disease that is rare quite, most often diagnosed in childhood. The tumor is noticeable visually, the symptomatics is expressed at mechanical damage or bacterial, viral infection. The main method of treatment is the surgical intervention, the choice of the excision method depends on the type and features of the tumor. After the operation, drug treatment is prescribed, the forecast is most often positive.

Side cysts are a consequence of congenital pathology for the development of the fetus, while the middle cyst of the neck of the child is diagnosed between the ages of 4 and 7 years, it can often flow asymptomatic. In half cases, the neoplasm is applied, which leads to emptying of the glance and the formation of a fistula.

Causes of disease

Classification of disease

side or branchogenic;

Localization of cyst and fistula neck

venous hemangioma;
fat tumors.

Symptoms of Disease

weakness, lethargy;

increased body temperature;
weakness, dizziness;

Symptoms of a cyst of the neck

Diagnostics

blood test to oncomarkers;
Uzi Neck;
fistulography;
CT if necessary.

Treatment of disease

Prevention

Other congenital anomalies [Development Vices] Persons and Neck (Q18)

Excluded:

clear lips and sky (Q35-Q37)
conditions classified in category Q67.0-Q67.4
congenital anomalies of zilly and facial bones (Q75.-)
cyclope (Q87.0)
prutscent anomalies (including bite anomalies) (K07.-)
congenital face lesions syndromes (Q87.0)
preserved thyroid language duct (Q89.2)

own sinks are innate
shaino-ear

Preda compensive sinus and cyst

Glaba Greet Development Anomaly

Hypertrophy lips in the birth

Medial:

face and Neck Cyst
fistula Faces and Neck
sinus face and neck

Congenital Anomaly of Face and Neck BDU

In Russia, the International Classification of Diseases of the 10th Review (ICD-10) adopted as a single regulatory document for accounting for incidence, reasons for people's appeals to medical institutions of all departments, causes of death.

The ICD-10 has been introduced into the practice of health throughout the territory of the Russian Federation in 1999 by order of the Ministry of Health of Russia from 27.05.97. №170

A new revision (ICD-11) is planned to be planned in 2017 2018.

With changes and additions to WHO.

Processing and transferring changes © MKB-10.com

Neck cyst - Major varieties and treatment

Pathology is rarely diagnosed, occurs in 2-5% of all tumors of the maxillofacial zone and the cervical department.

Development mechanism

Most often, the cyst is not dangerous, but some varieties, cystic hygroma in particular, becomes the cause of the child's intrauterine death.

Classification

There are several groups of classifications on the structure of the tumor and the location of localization (in front, on the side, rear).

Varieties by nature of education:

brangiogenic cyst (gill) - is formed due to pathologies of the development of the embryo, in the course of its growth, the unrelated gill pockets are filled with liquid;
the dermoid cyst of the neck is filled with the cells of the coarse and sweat glands, connective tissue;
lymphogenic - arises as a result of lymph dysfunctions, filled with serous fluid;
cystic - distributed among children, in 90% of cases require surgery;
epidermal - is formed due to clogging of the sebaceous gland epidermal cells, occurs near the spine on the hair growth line.
the median cyst develops as a result of injuries, infections, blood diseases and lymphs, in 50% of cases, pathology is accompanied by the suppuration, the formation of fistulas that open into the oral cavity or outwards; Through the fistula, purulent fluid comes out, its penetration into the body can cause strong intoxication.

Symptoms

The neoplasms are less than 1 cm visually invisible, only a professional doctor can establish its presence.

As a result, the following symptoms arise:

tissue swelling, swallowing pain;
mobility of the neoplasm;
inflammation of lymph nodes;
large deformation;
abscess - after filling in gently and inflammation, abscess or sepsis develops, which leads to infection of blood, inflammation of tissues, necrosis and infection of the whole organism.

Diagnostics

Treatment

The only way to treat cyst is considered surgical removal, drug therapy is ineffective. In children, the operation is carried out after the achievement of the three-year-old age - in adults after the detection of pathological symptoms. The removal method is chosen after a thorough study of the neoplasm, the establishment of its species, sizes and other individual characteristics. The duration of the operation does not exceed the hour, it is required to carry out general anesthesia. Intervention requires professionalism and attention, incomplete removal threatens recurrence, the operation is carried out in the outpatient conditions, there is no need for hospitalization.

Cystous formations are characterized by sensitivity to any thermal procedures, therefore, self-medication in this case is strictly contraindicated, compresses and rods can cause damage organis.

Indications for surgery:

excess the size of a tumor 1 cm;
pain;
difficulties when swallowing and pronouncing phrases.

Features of the operation:

Officially plays an important role, with serious diseases and old age, the operation is contraindicated. Instead, the content of the neoplasm is removed, after which the cavity is purified by antiseptic means.
The aggravation of the inflammatory process - the cavity is revealed, drainage is carried out, the mine is removed, the operation is carried out after 2-3 weeks of anti-inflammatory therapy, the capsule is re-washed. Sometimes there is no need for operational intervention, since the cavity is headlong in itself.
The removal of small cyst can be carried out through the oral cavity, such a method avoids the formation of seams.
Large tumors are removed through skin cuts, special caution is required when removing side neoplasms, as they affect the nerves.
The median cyst is connected to the sub-bandy bone, so the tumor is removed together with its part.
The operation is complicated by the presence of fistula, to identify all the subtle yields of which the contrast agent helps. In the lateralization of the cyst, the situation is dried by the presence of large blood vessels.

The probability of recurrence increases with diagnosed lymphadenitis, to avoid re-education of cysts will help the course of special rinsing, sharp and coarse dishes should be excluded from the diet.

Prevention

Forecast

Conclusion

The neck of the neck is a congenital disease that is rare quite, most often diagnosed in childhood. The tumor is noticeable visually, the symptoms are expressed in mechanical damage or bacterial, viral infection. The main method of treatment is the surgical intervention, the choice of the excision method depends on the type and features of the tumor. After the operation, drug treatment is prescribed, the forecast is most often positive.

Congenital malforms of the development of the face and neck

RCRZ (Republican Center for Health Development MD RK)

Version: Archive - Clinical Protocols MH RK (Order No. 239)

general information

Short description

Systemic disorders within the boundaries of the first and second gill arcs during the period of the embryonic development of the child. Common for all syndromes - dysplasia and (or) underdevelopment of tissues and organs of the person, entailing functional and aesthetic disorders.

Protocol "Congenital defects of the development of the face and neck"

Q 18.1 - Congenital preurb of cyst and fistula

Q 18.4 - Macrotomy

Q 18.5 - microstomy

Q 18.6 - Macrohelia

Q 18.7 - Maikrohelia

Q18.8 - Other refined faces of the development of the face and neck

Q 38.2 - Macrogness

Q 38.3 - Other congenital anamalia language

Q 16.0-Q16.1 - congenital anomaly and atresia audit

Q 17.0 - Additional Own Sink

Q 17.1-Q 17.3 - Macrotia, Microaty and Other Ear Anomalies

Q 17.5 - protruding ears

Classification

Classification of congenital faces and neck (WHO, 1975)

Congenital faces of the development of the face:

Cleft lips;

Through clefts of the upper lip and sky;

Oblique clefts (coloboma);

Cross clefts (macrostomy);

Fistulas of the lower lip;

Hypertelorism (median nose cleft), etc.

Congenital malformations of the cultivation of the oral cavity and pharynx:

Short bridle of the language;

Dental defects;

Small spectrum of the oral cavity;

Congenital vices of earrings shells:

Dysplasia of abnormal sinks (microchips and anatics), the atresia of the auditory pass;

Old volumen fistulas (pre-fistulas and cysts);

Anomalies of 1 and 2 gill arcs, etc.

Congenital vices of the neck of the neck:

Middle and side fistula and neck cysts, etc.

Diagnostics

Complaints: on a cosmetic defect, violation of the anatomical functional integrity of the maxillofacial region (depends on the type of malformance).

The treatment of this pathology is surgical, and it is carried out in different age periods depending on the total symptom complex of the disease (plastic of the upper lip, plastic of the eyelids, contour plastic facial, reflare, etc.).

Treatment of median splashing nose surgical, depending on the severity of pathology. In easy cases, plastic wipers and the tip of the nose can be carried out. This operation can be carried out at an earlier age (13-15 years). In more severe cases, complete (including bone) rhinoplasty, which is carried out, as a rule, after 17 years. In addition, with pronounced hypertelectricism in adults it is possible to carry out a reconstructive operation on the frontal bone, the upper jaw, the zilly bones in order to normalize the face form. These rare and complex operations are carried out in some major clinics in maxillofacial surgery.

The treatment is to prevent asphyxia and aspiration of food from the first days of the child's life. For this, the language or lower jaw is fixed in the provenized position with the help of surgical or orthodontic methods. In some cases, it is enough to keep and hugging newborns on the stomach. Over time, the position of the lower jaw is stabilized by strengthening the muscles nominating the lower jaw. In the future, the rehabilitation of these children requires mogymnastics, orthodontic treatment and sky plastic in generally accepted terms.

Frankhety-colline syndrome or maxillofacial dysostics. The disease often has a family (hereditary) character. The characteristic symptoms of it is, unreserved the underdevelopment of the zick bones, the upper and lower jaws, the oars. For syndrome F.K. Characterized by the anti-monogoloid direction of the eye cracks: the eye slots are directed to each other at an angle due to the omission of the outer corners of the eyes (the eyes "house"). Often there is a colobome or underdevelopment of the eyelid. The underdevelopment of the upper jaw is accompanied by the underdevelopment of the maxillary sinuses, the anomalies of the teeth and bite. Ear shells are underdeveloped in varying degrees. In aplasia of the auricles, there is an atres of external hearing aisters with partial or complete deafness. Macrottoma, ear appendages are possible. Sometimes there are additionally found the middle cleft of the sky, cleaned upper lips.

Treatment of these patients in practice is most often palliative - elimination of teeth anomalies, bite or contour plastic facial. Reconstructive bone operations are rare.

Laboratory studies are not changed. Possible: hypochromic anemia, hypoproteinemia, which is associated with power disorders.

X-ray painting: depends on the type of malformation.

Indications for consultation of specialists - in the presence of concomitant pathology:

Consultation of the dentist, the gynecologist for the sanitation of the oral cavity infection and external genital organs;

Allergist in manifestations of allergies;

Violations by ECG and others. Are an indication for consulting a cardiologist;

In the presence of viral hepatitis, zoonous and intrauterine and other infections - infectious diseases.

Differential diagnosis: no.

List of major diagnostic activities:

1. Common blood test (6 parameters).

2. Common urine analysis.

3. Biochemical blood test.

4. Study Cala on Eggs Hist.

5. Determining the time of coagulation of capillary blood.

6. Definition of blood type and factor rhesus.

7. Consultation of a doctor of anesthesiologist.

List of additional diagnostic events:

1. Computer tomography head and neck.

2. Panoramic X-ray of jaws.

3. Ultrasound of the abdominal organs.

5. X-ray of jaw bones in two projections.

Neck cyst: symptoms and treatment

Neck cyst - main symptoms:

Weakness
Dizziness
Nausea
Vomot
Subfebrile temperature
Intoxication
Lethargy
Redness of the skin in place of defeat
Increased temperature in the affected area
Figure Mouth
Sweeping in the affected place
Deterioration of general condition
Pain when pressing for neoplasm
Cryer on the neck
The impossibility of full flexion of the neck
Child can't keep his head

Etiology

The median cyst in adults (thyreogolosal) may be a consequence of such etiological factors:

The exact causes of the development of the pathology of the gill slit and arc during the development of the fetus are not established. However, clinicians allocate such possible predisposing factors:

genetic predisposition - if a history of parents or one of them has such a pathological process, such a clinical manifestation may be observed in a newborn;
strong stress, constant nervous voltage of the mother during the nipping of the child;
abuse of alcohol and smoking;
treatment with "heavy" drugs during pregnancy, especially in early time. It should include antibiotics, anti-inflammatory, painkillers, corticosteroids;
systemic diseases in mothers;
the presence of chronic diseases.

In the presence of such a symptom, the child should immediately access the doctor. It is extremely dangerous to ignore such clinical manifestation, since the likelihood of a malignant tumor is greater.

Classification

Severe two main types of neoplasms on the neck:

side or branchogenic;
middle or thyrectural.

Side cysts, in turn, are divided into:

According to the structure and principle of education, such forms of neoplasms are distinguished:

the dermoid cyst of the neck - refers to congenital pathologies, lies on the surface, is not attached to the throat. As a rule, such a neoplary is filled with the cells of the sebaceous and sweat glands, the hair follicle;
zhabelnaya - located in the area of \u200b\u200bthe bone under the tongue, consists of the epithelium pants of the gills.

The following classification of the neck cyst can also be used, according to the nature of education and localization:

the hygroma is a soft and smooth education, which is located in the lower cervical department;
venous hemangioma;
primary lymphoma - a group of soldered compacted knots;
neurofibrome - fixed, dense consistency in education, diameter from 1 to 4 centimeters;
the thyroid-tongue - can be localized in the area of \u200b\u200bthe larynx and neck, moves up or down in the process of swallowing;
fat tumors.

Regardless of which ethiology in the neoplasm, it is subject to surgical removal, since the risk of transition to a malignant form is almost always.

Symptomatics

Some forms of neoplasm on the neck in children or adult can be asymptomatic. As the height of the tumor is growing, such symptoms may be present:

the impossibility of complete flexion of the neck;
at the palpation of the neoplasm, pain feels;
tumor movable, skin covers are unchanged, but it is possible to redness;
the child can not hold his head;
weakness, lethargy;
subfebrile body temperature, also possible local temperature increase;
signs of general intoxication of the body - nausea, vomiting, general ailment.

If the compensation process began, such symptoms of the clinical picture may be present:

local redness of the skin, humanity;
increased body temperature;
weakness, dizziness;
severe pain in palpation;
purulent exudate follows out, less often in the oral cavity;
the skin around the mouth can be covered with crusts.

In the presence of such clinical signs, immediately apply for medical attention. The purulent process can lead to abscess, phlegmon and other diseases, life-threatening.

Diagnostics

First of all, a physical examination of a patient with a palpation of cysts on the neck is carried out. Also during the primary survey, the doctor must collect personal and family history.

To clarify the diagnosis, such laboratory and instrumental research methods can be carried out:

puncture of fluid from hollow education for subsequent histological research;
blood test to oncomarkers;
Uzi Neck;
fistulography;
CT if necessary.

General clinical studies of blood and urine, in this case, do not represent diagnostic value, therefore are carried out only if necessary.

Treatment

The removal of lateral tumors is more difficult, since the neoplasm is localized near the vessels and nerve endings.

In the postoperative period, the patient should be observed a diet that implies the following:

from the diet for the period of treatment, it is necessary to exclude acid, sharp and too salty, coarse food;
drinks and dishes need to be used only for warm;
the dishes should be liquid or mashed.

If the surgical intervention is carried out in a timely manner, the risk of recurrence or development of the oncological process is practically absent. Long rehabilitation is not required.

Prevention

Unfortunately, in this case there are no effective methods of prevention. It is strongly recommended not to engage in self-medication and in a timely manner to see a qualified physician. In this case, the risk of developing complications is minimal.

If you think that you have a neck cyst and symptoms characteristic of this disease, you can help doctors: surgeon, therapist, pediatrician.

We also offer to take advantage of our services to diagnose diseases online, which, based on the entered symptoms, selects the likely diseases.

- This is a hollow pathological formation, which is located in the neck area and contains a liquid or a cascidious mass. Refers to the number of congenital pathologies, may be lateral or median. Side cysts are revealed immediately after birth, the median can be found as a child grows or becomes a random find during any medical research. Possible complications - suppuration, fistula and malignant rebirth. In most cases, neck cysts are subject to surgical removal. The puncture of the cysts is ineffective, because in its cavity, the contents are accurately accumulated. There is no conservative treatment.

General

Neck cyst is a hollow tumor formation, located on the front or side surface of the neck. It is formed with violations in the early stages of embryonic development. In some cases combined with congenital fistula Neck. Sometimes, the fistula is already formed in children or even adulthood as a result of the suppuration of the cyst. It is possible to rebirth the coast of the neck in a malignant tumor. Treatment only surgical.

The side cysts of the neck are usually detected at the birth of a child, the median is detected at the age of 4-7 or 10-14 years, sometimes they are asymptomatic. One of the 9-10 patients with a side cyst is observed in combination with congenital fistula. Approximately 50% of cases of cysts are caught up, and the fistula is formed as a result of the emptying of an umnut through the skin.

The reasons

The neck cyst of the neck is the cavity between the gill grooves, which should normally disappear as the fetus develops. It is formed with the abnormalities of the development of gill slots in the fourth-sixth week of pregnancy. The median cyst is formed when the thyroid fastener is moved from the place of formation to the front surface of the neck on the shield-pagan duct. This happens on the sixth seventh weeks of pregnancy.

Congenital fistula is not independent pathology and is always combined with a side or median cure neck. Two types of fistulas are distinguished: full (with two outlet holes: on the skin and oral mucosa) and incomplete (with one hole, which can be located both on the skin and on the mucous).

Types of cysts neck

Side cysts neck

The side cysts of the neck occur more often than the median (about 60% of cases). They are located on the front-side surface of the neck, in its upper or middle third, the kinsel from the mouse muscle and are localized directly on the vascular-nervous beam, next to the inner yarema velana. There are both multi-chamber and single-chamber. The side cysts of the neck of large size can squeeze the vessels, nerves and nearby organs.

Symptoms

In the absence of suppuration or compression of the vascular-nervous bunch of complaints. During the inspection, a rounded or oval tumor-like formation is detected, especially noticeable when the patient's head turns in the opposite direction. Palpation is painless. The cyst has an elastic consistency, mobile, does not match the skin, skin surfaces are not changed over it. As a rule, fluctuation is determined, indicating the presence of fluid in the cavity of the cyst. When puncture in the cavity of the formation, a dull liquid of a dirty white color is detected.

Complications

With the suppuration of the ebony, the neck increases in the amount becomes painful. The skin blushes over it, the local edema is revealed. Subsequently, a fistula is formed. When opening on the skin, the mouth of the fistula is located in the front edge of the mouse muscle. When opening on the oral mucosa, mouth is located in the region of the upper pole of the sky almond. The hole can be both point and wide. The skin around the mouth is often covered with crusts. There is a maceration of skin and hyperpigmentation.

Diagnostics

The diagnosis of the side cyst of the neck is exhibited on the basis of anamnesis and clinical picture of the disease. To confirm the diagnosis, puncture followed by a cytological study of the resulting liquid. Such additional research methods can be used as ultrasound, sensing and fistulography with an x-ray infant.

With a non-infected neck, a differential diagnosis with lymphogranulomatosis and ecanegred neck tumors (lipoma, neurinoma, etc.) is carried out. The ventricular cyst is differentiated from adenoflems and lymphadenitis.

Middle cysts neck

Symptoms

Middle cysts in traumatology make up about 40% of all the neck cyst and are located on the front surface of the neck, along the midline. In case of inspection, a dense, painless, clearly delimited formation of elastic consistency with a diameter of up to 2 cm is deficated, not soldered with the skin. The cyst is slightly moving, fasting with the body of the sub-band bone, shifts when swallowing. In some cases, tumor-like education is located at the root of the language. At the same time, the language is raised, there are violations of speech and swallowing.

Complications

Middle cysts are applied more often by side - about 60% of cases. When infection, education increases in the amount becomes painful. The surrounding fabric swells, the skin blins. When opening an ulcer, a fistula with a mouth is formed located on the front surface of the neck, between the thyroid cartilage and the sub-bandy bone. If the fistula opens into the oral cavity, its mouth is located on the front surface of the tongue, on the border between its root and body.

Diagnostics

The diagnosis of median cyst is exhibited on the basis of anamnesis and clinical data. As methods of instrumental diagnostics use ultrasound and puncture of cysts followed by cytological studies. The puncture is obtained by a dull muddy liquid of yellowish color, containing lymphoid elements and cells of a multilayer flat epithelium. Fistulography and sensing is used to study fistulous moves.

The median trash cyst is differentiated from the strips of the tongue, dermoid cyst, lymphadenitis, specific inflammatory processes and adenoma of an abnomially located thyroid gland.

Treatment of a cyst neck

Treatment of neck cyst only operational. The volume of operation is determined by the condition of the patient, the presence and type of complications. The elderly patients with severe concomitant diseases are aspiration of the contents of the cyst, followed by washing its cavity by antiseptic preparations. In other cases, this method is not used due to insufficient efficiency and high risk Development of recurrences.

Uncomplicated cysts. The surgical removal of the neck cyst is shown at all side cysts, median cysts of any size in childhood and median cysts with a diameter of more than 1 cm in adults. To prevent relapses, the cyst excite together with the capsule. In surgical interventions about the average cyst, a part of the sub-bandy bone is also removed through the tumor education. During operations on the side cyst, difficulties are possible due to nearby vessels and nerves. Depending on the size of the cyst of the root of the tongue can be removed both through the cut on the skin and through the mouth.
Voiced cysts. With the suppuration of the cyst, its complete deletion is not shown. Opening and drainage is performed. An indication of an emergency operation is the presence of an acute inflammatory process, especially when closing the fistula and the formation of abscess. Subsequently, regular transsings are carried out with a cyst cavity by antiseptic drugs, anti-inflammatory therapy is assigned. Sometimes the cavity of the cyst is chuck. If this does not happen, its removal is carried out no earlier than 2-3 months after the liquidation of inflammation.
Cysts with fistulas. The median and side fistures of the neck must be excised and deleted. This task can be associated with a number of difficulties due to the thin wall and the winding moves of the fistula. Therefore, a probe or staining drug (diamond green, methylene blue) is introduced before surgery in the fistulmony. During the operation, all the fistulous moves are removed, including thin and low-wing, otherwise recurrence is possible. Special complexity is characterized by an operation on excision of the side fistula, since in this case the fistula runs between the internal and external carotid arteries.

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general information

Short description

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Treatment

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Symptoms