Al-Azhar Assiut Medical Journal (Apr 2024)
Management of forearm ganglion: a comparative study from a medical college hospital
Abstract
Background Ganglionic cysts are smooth, fluctuant benign tumors of forearm commonly encountered in our day-to-day outdoor practice. The study aims to compare the efficacy, safety, and recurrence rates of triamcinolone, mixture of triamcinolone and hyaluronidase, and surgical excision in our tertiary care hospital. Patients and methods This prospective comparative study was carried out in the SKIMS Medical College and Hospital over a period of 3 years. A total of 96 participants between January 2018 and January 2021 with forearm ganglion were included and treated in three groups: group A included patients who had aspiration and injection of triamcinolone; group B patients had aspiration and injection of a mixture of triamcinolone and hyaluronidase; and group C patients underwent excision under local anesthesia. The data was collected and analyzed. Results Among 96 patients who met the inclusion criteria, the mean age was 35.74 years, with a male:female ratio of 0.63. Swelling was the most common clinical presentation recorded in 100% patients. Swelling with symptoms like pain, paresthesia, etc., was present in 59.38%, dissatisfaction with cosmetic appearance in 55.21%, and 36.46% patients had apprehension of a sinister lesion (malignant tumor). Of the patients, 47.92% had aspiration and injection of triamcinolone (group A); 43.75% patients had aspiration and injection of a mixture of triamcinolone and hyaluronidase (group B); and 8.33% patients underwent surgical excision (group C). In group A, 15.22% patients had recurrence, while only 2.38% patients developed recurrence in group B. We observed a 100% success rate after surgical excision. There was significantly positive relation between group A and group B treatment protocols and recurrence rates (P≤0.05). None of our patients developed any major post-procedural complications. Conclusion Aspiration and intra-cystic instillation of a mixture of triamcinolone and hyaluronidase is a simple, effective, safe treatment of ganglion with low recurrence rates as compared with triamcinolone alone. Surgical excision after failed primary treatment with aspiration and injection showed excellent results.
Keywords
