Treatment Options
3) Treatment options: There are three main treatment options for ganglia. First, it is possible to leave it alone if it isn't causing any discomfort; ganglia are harmless. Once the diagnosis is made and the patient is reassured that the mass isn't cancer or something else which requires immediate attention, the patient may wish to just watch and wait. If the ganglion is causing discomfort or mechanical problems, there are two main options for relief: aspiration (removal of the cyst contents with a needle) and surgical removal of the cyst itself.
Aspiration involves inserting a needle into the cyst and removing its contents after numbing the area with a local anesthetic. Because it is thought that inflammation contributes to the production and accumulation of the fluid in the cyst, an anti-inflammatory drug (steroid) is often then injected back into the cyst in an attempt to decrease the inflammation and prevent subsequent refilling of the cyst. Recent research found that using another substance (hyaluronidase, an enzyme used in the treatment of certain forms of arthritis to promote resolution of redundant tissue) along with the steroid after aspiration increased the cure rate from 57% (aspiration and steroid alone) to 89% with the combined substances.
If the cyst is disfiguring, causes pain, mechanical problems, nerve complications (motor or sensory loss due to pressure by the ganglion on a nerve), or recurs after a previous aspiration, then surgical excision is warranted. This involves making an incision over the area of the cyst, identifying the entire cyst, and removing it along with a portion of the underlying tendon sheath or joint lining from which it originates. The hand is then splinted for 7 to 10 days. The procedure is usually fairly minor, but can be complicated depending on the location of the cyst and whether it impinges on any vital structures in the hand (nerves, tendons, blood vessels). It is important to discuss the different treatment options with your physician if you are diagnosed as having a ganglion cyst.
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