Lawrence Ajekigbe1, John Stothard. 1. Department of Plastic Surgery, The James Cook University Hospital, Middlesbrough, United Kingdom.
Abstract
BACKGROUND: Ganglia are the most common benign soft tissue tumours of the hand. Although benign, a significant number of patients with wrist ganglia consult with their general practitioners, and ultimately the hand surgeon, complaining of pain. A great number of patients are concerned about the cosmetic appearance, and an equally significant number genuinely believe that the ganglion is a cancer. There are several management options resulting in varying degrees of success. These include observation only, surgical excision, aspiration only, aspiration with injection of methylprednisolone, and aspiration with injection of methylprednisolone and hyaluronidase. OBJECTIVE: The main objective was to investigate the effectiveness and safety of sodium tetradecyl sulfate as a sclerosing agent after aspiration of wrist ganglia. METHODS: Initial data were collected prospectively during a period of 48 months. Following this, patients were sent a postal survey at least two years after they had received treatment to access the levels of recurrence and persistent complications. RESULTS: In the short term, 90% of the patients achieved complete resolution after one episode of aspiration and injection. However, there was only a 65% cure rate after two to five years. Complications were few and not significant. CONCLUSION: Sodium tetradecyl sulfate is an effective sclerosing agent after aspiration of wrist ganglia with an excellent short-term efficacy and a long-term cure rate comparable to that of surgical excision.
BACKGROUND: Ganglia are the most common benign soft tissue tumours of the hand. Although benign, a significant number of patients with wrist ganglia consult with their general practitioners, and ultimately the hand surgeon, complaining of pain. A great number of patients are concerned about the cosmetic appearance, and an equally significant number genuinely believe that the ganglion is a cancer. There are several management options resulting in varying degrees of success. These include observation only, surgical excision, aspiration only, aspiration with injection of methylprednisolone, and aspiration with injection of methylprednisolone and hyaluronidase. OBJECTIVE: The main objective was to investigate the effectiveness and safety of sodium tetradecyl sulfate as a sclerosing agent after aspiration of wrist ganglia. METHODS: Initial data were collected prospectively during a period of 48 months. Following this, patients were sent a postal survey at least two years after they had received treatment to access the levels of recurrence and persistent complications. RESULTS: In the short term, 90% of the patients achieved complete resolution after one episode of aspiration and injection. However, there was only a 65% cure rate after two to five years. Complications were few and not significant. CONCLUSION:Sodium tetradecyl sulfate is an effective sclerosing agent after aspiration of wrist ganglia with an excellent short-term efficacy and a long-term cure rate comparable to that of surgical excision.