Transoral endoscopic excision of cystic hygroma vestibular approach in adult (novel approach): a case report

Authors

  • Raj N. Gajbhiye Department of Surgery, GMC Nagpur, Maharashtra, India
  • Ganesh K. Kharkate Department of Surgery, GMC Nagpur, Maharashtra, India
  • Vidhey S. Tirpude Department of Surgery, GMC Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203810

Keywords:

Endoscopic cystic hygroma, Cystic hygroma, Vestibular approach

Abstract

Lymphangioma, soft tissue tumor was originally reported by R. Backer in 1828 and “cystic hygroma” name was first given by Wernker in 1834. It can occur in the head, neck, axilla, cervico-facial regions and below tongue. Although it is well recognized in children, it may present in adulthood. Cystic hygroma neck is traditionally removed via an overlying incision near or over the swelling. The resultant scar can be displeasing to an adult. Various endoscopic approach present in literature for excision are via neck, anterior chest, combined or robotic assisted. We here, are reporting transoral endoscope excision of cystic hygroma via vestibular approach. A 51 year old female with swelling over anterior aspect of neck, trans-illumination positive, diagnosis confirmed on CT neck, of size ~4×4 cm was our case. We decided for transoral endoscopic vestibular approach for excision, first of its kind with no assisted approach. Patient discharged after 3 post-operative days (PODs). There was mild seroma which resolved within a week. Transoral endoscopic excision of cystic hygroma via vestibular approach without any assisted approach can be applied in adult. Various approach present in literature for excision of cystic hygroma are via neck, anterior chest or combined or robotic assisted. Hence this approach can be an excellent choice for adult cystic hygroma patients who desire to avoid a neck incision. Transoral endoscopic excision of cystic hygroma via vestibular approach was successfully performed. Patient was satisfied with good cosmosis. It results in good cosmesis and better dissection. Hence can be a new method of excision of cystic hygroma in adult.

Metrics

Metrics Loading ...

Author Biographies

Raj N. Gajbhiye, Department of Surgery, GMC Nagpur, Maharashtra, India

Professor & HOD, Department of General Surgery

Ganesh K. Kharkate, Department of Surgery, GMC Nagpur, Maharashtra, India

Senior Resident, Department of General Surgery

Vidhey S. Tirpude, Department of Surgery, GMC Nagpur, Maharashtra, India

Senior Resident, Department of General Surgery

References

Fidan V, Sutbeyaz Y. Lingual cystic lymphangioma in an elderly patient. Yaşlı bir hastada lingual kistik lenfanjiyom. 2008;18(4):260-2.

Gowa L, Rampat R, Khanb A, Mihaimeed F. Adult-onset cystic hygroma: a case report and review of management. Gd Rounds. 2011;11:5-11.

Zainine R, El Aoud C, Sellami M, Beltaief N, Sahtout S, Besbes G. Cystic hygroma: report of 25 cases. Tunis Med. 2012;90(1):19-24.

Lin FCF, Yang TL, Tung MC, Tsai SCS. Robot-assisted excision of cervical cystic hygroma through a retroauricular hairline approach: a case report. J Med Case Rep. 2016;10(1):154.

Han P, Huang X, Cai Q, Sun W, Liang F, Guo M, et al. Endoscope-assisted excision of macrocystic lymphangioma in neck via anterior chest approach in infants and children. Int J Pediatr Otorhinolaryngol. 2011;75(10):1275-9.

Le Q V, Ngo DQ, Ngo QX. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): a case report as new technique in thyroid surgery in Vietnam. Int J Surg Case Rep. 2018;50:60-3.

Anuwong A, Sasanakietkul T, Jitpratoom P, Ketwong K, Kim HY, Dionigi G, et al. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc. 2018;32(1):456-65.

Saxena P, Chandra D. Cystic hygroma of neck in an adult female : case report and literature review. 2009;22(2):2-5.

Derin S, Sahan M, Dere Y, Cullu N, Sahan L. Cervical cystic hygroma in an adult. Case Rep Pathol. 2014.

Morley SE, Ramesar KC, Macleod DA. Cystic hygroma in an adult: a case report. J R Coll Surg Edinb. 1999;44(1):57-8.

Downloads

Published

2020-08-27

Issue

Section

Case Reports