Surgery of a cyst on the neck

They are caused by disorders of the deterioration of the thyroglar canal and improper development of the gill arch on the neck, and are mostly harmless.

In most cases, they are painless and are most often removed for aesthetic reasons. However, if it is not removed, there is a possibility of developing a cyst infection, which causes complications such as an increase in the size of the cyst, pain, pressure on the surrounding anatomical structures and limited mobility of the neck.

Surgery of a cyst on the neck is therefore the only solution in preventing the development of any complications on the neck.

There are two types of cysts on the neck; medial and lateral cysts. Although both cause similar problems, there is a difference in their occurrence and development.

These two types of cysts differ the most in the place of origin – the medial cyst usually appears in the midline of the neck, above the level of the larynx, while lateral cysts are located on the sides of the neck and surrounded by important structures such as the hypoglossal nerve, carotid artery, accessory nerve.

1.Medial cyst on the neck

Medial cysts on the neck are formed at the embryonic stage of development. Namely, in this phase, your thyroid gland is located under the tongue, and during the development of the embryo, it moves slightly towards the neck and permanently stays in the area in front of and below the larynx.

The passage that is formed by the thyroid gland traveling from the tongue to the neck is called the thyroglosal duct. Once the thyroid gland is located in its anatomical location, the thyroglosal canal deteriorates and becomes part of the connective tissue.

But in some cases, the thyroglosal duct does not completely collapse, but leaves behind small pockets in the tissue, a capsule is formed, which is then filled with cellular fluid.

You can notice medial cysts by a spherical soft formation under the chin and above the larynx.

2. Lateral cyst on the neck

Unlike the medial one, the lateral cyst is formed when the gill arch develops on the neck.

The gill arch is considered an essential segment in the embryonic stage of development of the organism. This six-part system is responsible for the development of organs, muscles, bones and nerves of the head and neck, and from each arch one part of the squash develops.

Thus, for example, parts of the jaw and facial muscles develop from the first gill arch. During the formation of new tissues, growth irregularities can occur, and as a consequence, new channels can form.

These ducts can fill with cellular fluid and stay forever between the muscles of the neck, bones and surrounding structures.

The resulting lateral cyst can appear in two forms: as a thickening in the neck or as a canal with an opening in the skin, even better known as a fistula. A mucous fluid can often be secreted from the fistula, and the entry of foreign organisms, such as bacteria, can very easily lead to infection.

Both lateral and medial cysts in the neck are best treated with surgical removal. By removing the cyst, the possibility of developing further complications is eliminated, and you also remove a visible formation on the neck that is aesthetically intrusive

Cysts on the neck are often removed for aesthetic reasons. However, in the case of a significant enlargement of the cyst, it can lead to difficulty swallowing, poor nerve function and finally an infection that can be accompanied by pain and redness.

In the case of a fistula, the secretion of an unpleasant-smelling mucous fluid is possible, or even the formation of an abscess (purulent accumulation formed in the capsule). From this situation, an infection can very easily develop, which can spread both to the surrounding structures and to the deep regions of the neck, where vital structures are located.

Before we decide to have a cyst surgery, we perform various diagnostic examinations and analyzes at the Lohuis Filipović Polyclinic. With these examinations, we collect the necessary information about the cysts and your vital functions.

To be sure that the operation is carried out, our method of diagnosis consists of several examinations:

• ENT examination

This examination is a fundamental method in diagnosing all diseases related to the ear, nose and throat. ENT examination We determine the location, size, consistency, soreness and mobility from the base of the cyst itself, and thus obtain additional information necessary for further diagnosis and treatment.

• Ultrasound examination

With ultrasound , we can clearly identify a cyst in the neck. This examination is non-invasive, which makes it suitable for children.

With a scan of the cyst, we can also recognize the surrounding squash and react if we notice something suspicious, such as a thickened lymph node or an enlarged thyroid.

• MSCT of the head and neck

Sometimes a complementary imaging method is required in addition to ultrasound of the neck, in order to assess the location of the cyst in relation to the surrounding important structures – primarily the carotid artery.

• Cytological puncture

To make sure that it is a cyst and not some other disease, such as a tumor, we perform a cytological puncture. As one of the biopsy methods, this examination is done by taking a tissue sample that is later analyzed under a microscope.

The sample is taken with needle, and the examination usually hurts no more than a blood draw.

Due to the use of general anesthesia, we also perform laboratory tests and ECG recordings. The results obtained will be used to compare your condition during the operation.

Based on your normal vital functions, we will be able to notice any deviations that may indicate complications during the procedure.

If you have had experience with the following problems, be sure to let us know so that we can adjust the course and method of surgery:

• Allergies to anesthesia

If you are allergic to the use of anesthesia, we may have to postpone or completely write off the possibility of performing a surgical procedure

• Blood clotting disorders

If you have blood clotting disorders, any surgery is associated with an increased risk of heavy bleeding and difficult recovery.

Before the surgery, you will fill out a form in which you give your consent to the use of general anesthesia. The form will describe in detail the procedure of the operation and possible complications during recovery.

In order for the surgery to go without major complications and for recovery to be as fast as possible, you will need to adhere to the following guidelines before your arrival:

• The day before the operation, do not smoke or consume alcohol
• Before the operation, eat light food, and come to the operation on an empty stomach
• Avoid consuming blood-thinning tablets (Andol, Aspirin)

Upon arrival at the clinic, you will lie down on the operating table, and the anesthesiologist will put you under general anesthesia. Due to the action of general anesthesia, you will not remember the procedure and you will not feel any pain.

Once you are in an unconscious state, the operation can begin. The surgical procedure is performed by an otorhinolaryngology specialist and a head and neck surgeon.

The operation begins with an incision over an area of skin protruding with a spherical formation – a cyst. When an incision is made, the surgeon carefully moves the surrounding structures so as not to injure them, and a cyst occurs. During the operation of a medial cyst, the surgeon also removes part of the hyoid bone that is connected to the cyst.

Once the cyst is removed by the surgeon, the wound is closed with degradable sutures under the skin, and postoperative patches are placed on the skin.

To avoid fluid collection, drainage will be installed overnight.

After the surgery, you will most likely spend the night in the polyclinic. On the second day, we remove the drainage and let you go home.

For the first week, avoid too much strain on the neck or sudden jerks of the head so as not to open the wounds under the skin.

You are allowed light physical activity, which you are allowed to increase in intensity over time.

After surgery of a cyst in the neck, various side effects are possible, depending on the type of cyst that has been removed. However, if the procedure is performed correctly, the chances of developing complications are small.

Side effects of removal of a medial cyst:

• Changes in the timbre of the voice – occurs as a result of injury to the upper laryngeal nerve. The change in voice timbre is almost imperceptible, but it is somewhat more significant in professional singers, actors or announcers.

• Postoperative bleeding – this complication in most cases occurs 24 hours after surgery, and in case of increased bleeding, it is necessary to reopen the wound, disinfect it and close it with new sutures.

• Infection – you can recognize an infection by pain at the site of surgery, redness and swelling, and sometimes by the appearance of pus on the surface of the skin. The infection is treated with antibiotics in most cases, and sometimes it will be necessary to reopen and clean the wound.

Side effects of lateral cyst removal:

• Difficult and poorly understood speech – occurs due to injury to the hypoglossus nerve, which is responsible for the proper function of the tongue. Nerve injury can result in paralysis of the tongue muscles on the side where the cyst was removed.
• Horner’s syndrome – occurs as a result of an injury to the cervical ganglia, and can result in problems such as a drooping upper eyelid, a narrow pupil and a retracted eyeball.
• Painful shoulder syndrome – as a result of injury to the accessory nerve

• Postoperative bleeding

• Infection

At the Lohuis Filipović Polyclinic , we perform cyst surgery almost every day. We are aware that the presence of cysts can cause visually repulsive sights, but also serious problems, such as infections that can spread to the surrounding areas in the neck.

Neck cyst surgery is a painless procedure with rare complications, and you can return to your daily activities almost immediately after leaving the clinic.

If you notice thickening in the neck and suspect phenomena such as cysts, lymph nodes or even thyroid problems, feel free to contact us at +3851 2444 646 and make an appointment.

If you forget to describe all the problems you have experienced during a phone call, you can describe everything that is bothering you in detail through our online form.