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Ganglion Removal

What is a ganglion?

A ganglion cyst is a very common, benign lump, filled with jellylike fluid. It forms mostly on the top of the wrist, the palm side of the wrist, or the base or top of the fingers, and sometimes on the ankle or on the feet. They appear along tendons or joints. The cyst is typically round or oval shape, soft or firm, and its size can vary from pea to walnut size.

How does a ganglion cyst form?

Ganglion cysts are formed along a joint or the tendon sheath, as an outpouching of a weakened portion of the joint capsule or tendon sheath. Inside this protrusion, synovial fluid accumulates and congeals. It creates a small, connecting bag first, then later it separates from the tendon sheath and creates a fluid-filled cyst.

The cause of the ganglion cyst is unknown, they may form in the presence of joint or tendon irritation or mechanical changes. An earlier trauma of the limb, exertion, joint wear, tendon sheath inflammation, exaggerated sports activity could also contribute to the emergence of a ganglion cyst.

Ganglion cysts occur in patients of all ages, but most common among women, between the age 20-40.

The size of the cyst may vary, it could increase, decrease, disappear or reappear, depending on the load of the limb.

What are the symptoms of a ganglion cyst?

The common symptom of a ganglion cyst is the appearance of an oval or round shape, fluid-filled lump on the wrist, ankle or the knee. It could be soft or firm as well: cysts at the base of the fingers, on the palm side, are usually very firm, and the ones on the dorsal wrist are usually soft.

The cyst becomes visible in the stretched position of the limb and by bending, it shrinks to the joint.  The cyst is usually painless, but if it presses a nerve, it can cause pain, tingling numbness or muscle weakness.

The deformity could cause psychical symptoms too, anxiety or frustration might occur due to the non-aesthetic node.

Ganglion cysts on the hand
Ganglion cysts on the hand

How ganglion cyst is treated?

The diagnosis is usually based on the location, touch, and shape of the cyst. Your orthopedic specialist may request imaging diagnostic procedures, such as MRI, CT or X-ray, to confirm the diagnosis and exclude other joint lesions.

The treatment depends on the caused symptoms. If the cyst is painless, simple observation is enough, as they frequently disappear spontaneously. The treatment usually starts with conservative therapy, including splints, anti-inflammatory medications to decrease pain associated with activities. If the conservative therapy was not effective, surgical removal is recommended.

When is surgical intervention needed?

Surgical intervention is recommended if the cyst cause complaints besides the deformity. If the cyst presses a surrounding nerve, causing numbness, muscle weakness, or becomes painful or limits activity, the excision is advised. Furthermore, if conservative treatments didn’t take effect, surgical removal could be the solution.

The aspiration of the fluid is not a final solution, as the recurrence of the cyst is very common because the sheath of the cyst stays between the tissues and it can be filled with fluid again.

Nevertheless, with surgical removal the entire cyst is removed, the sheath is excised, so the chance for the recurrence is minimal.

What happens during the surgery?

The surgery is always preceded by a personal consultation with the hand surgeon specialist. During the consultation, he provides detailed information about the necessary pre-operative tests, the process of the operation and its risks.

The surgery is usually performed as a 1-day surgery, under local anesthesia. The aim of the surgery is to locate the origins of the cyst and to remove the structure completely by excision. This is often associated with the removal of a small part of the joint capsule and/or of the tendon sheath.

After the excision, the wound is closed with a few stitches by the surgeon.

What are the risks of the operation?

Like every surgical intervention, the ganglion cyst excision may have risks and complications. Very rarely the operational area may become inflamed, infected, and the adjacent anatomical structures – tendons, muscles, blood vessels, nerves, neighboring bones – may get injured. In some cases, pharmaceutical treatment may be needed, while in more severe cases the operation might have to be repeated. The most serious complication may be the inflammation of the treated area, which can be prevented by the strict adherence to the hygiene rules.

What shall I do after the surgery?

After a few hours of medical monitoring, the patient can leave our hospital. The day after the surgery, the bandage should be changed, and the removal of the stitches is due 10 days after the intervention. During these days, keep the wound away from water.

The wound may remain swollen, sensitive and painful for a few days after the surgery. Spare the limb to faster the healing process, which might take approximately 2 weeks, depending on the individual.

Patient room - Medicover Hospital Hungary

How much does a ganglion cyst removal cost?

The price of a ganglion cyst removal is composed of several elements. At our hospital, the listed ganglion cyst surgery cost includes the surgery and the check-up one week after surgery.

We offer a separate consultation package for the first consultation, where the hand surgeon specialist decides if the surgery is recommended. The necessary pre-operative examinations can be taken at our hospital, which has an additional cost.

Our goal is to offer you the most reasonable ganglion cyst removal price for the highest quality service and care.