#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Ultrasound-guided percutaneous ethanol injection therapy of neck cysts as an alternative to surgery


Authors: M. Halenka 1;  Richard Salzman 2;  Munteanu H. 3;  M. Brož 2;  Schovánek J. 1;  Z. Fryšák 1
Authors‘ workplace: III. interní klinika – nefrologická, revmatologická, endokrinologická LF UP a FN Olomouc 1;  Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN Olomouc 2;  Interní gastroenterologická klinika LF MU a FN Brno 3
Published in: Otorinolaryngol Foniatr, 70, 2021, No. 3, pp. 181-189.
Category: Case Reports
doi: https://doi.org/10.48095/ccorl2021181

Overview

Introduction: Some extrathyroidal cervical cystic lesions can be treated in selected situations by minimally invasive, low-risk method – ultrasound-guided percutaneous ethanol injection therapy (US-PEIT). Here we present 6 cases of neck cysts of various origins – ranula, thyroglossal duct cyst, branchial cleft cyst, midline neck cyst of the pyramidal lobe and dermoid cyst. Method and material: The cohort consisted of 6 patients (mean age 58 ± 13.3 years), who were followed for recurrent cervical cysts located outside the thyroid gland. The cysts were visible, palpable, aesthetically unpleasant and also mechanically compressing the surrounding tissue. After repeated evacuations, they filled in again. The patients repeatedly refused the recommended surgery and demanded an alternative solution. US-PEIT of thyroid cysts is used worldwide as a full-fledged alternative to surgical treatment. We used the same procedure for the treatment of presented neck cysts. Results: The initial volume of cysts was 2–35 mL (mean 17.7 mL); the patients underwent 1–6 sclerotization sessions (mean 3.6). The patients were followed for 12 months; the final volume of solid residue was 0.1–2 mL (mean 1 mL) representing volume reduction by 80–99% (mean 92%). Therapeutic success (volume reduction > 50%) was achieved in all patients. Conclusion: US-PEIT of cervical cysts as an alternative to surgery can be used especially in elderly patients with increased surgical risk or in patients refusing surgery. In middle-aged and older adults, the possibility of a necrotic metastatic lymph node should always be considered. Therefore, a benign cytological examination and an unsuspecting ultrasonographic and CT finding are the basic conditions before performing the ethanol ablation.

Keywords:

neck cysts – ultrasound-guided percutaneous ethanol injection therapy


Sources

1. Mittal MK, Malik A, Sureka B et al. Cystic masses of neck: A pictorial review. Indian J Radiol Imaging 2012; 22 (4): 334–343. Doi: 10.4103/0971-3026.111488.

2. Patel S, Bhatt AA. Thyroglossal duct pathology and mimics. Insights Imaging 2019; 10 (1): 12. Doi: 10.1186/s13244-019-0694-x.

3. Halenka M, Fryšák Z. Atlas ultrasonografie štítné žlázy. 2. vyd. Praha: Maxdrof – Jesenius; 2018.

4. Kim DW, Rho MH, Kim HJ et al. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous? Am J Neuroradiol 2005; 26 (8): 2122–2127.

5. Chung MS, Baek JH, Lee JH et al. Treatment efficacy and safety of ethanol ablation for thyroglossal duct cysts: a comparison with surgery. Eur Radiol 2017; 27 (7): 2708–2716. Doi: 10.1007/s00330-016-4659-x.

6. Kim SM, Baek JH, Kim YS et al. Efficacy and safety of ethanol ablation for thyroglossal duct cysts. Am J Neuroradiol 2011; 32 (2): 306–309. Doi: 10.3174/ajnr.A2296.

7. Ryu KH, Lee JH, Lee JY et al. Ethanol Ablation of Ranulas: Short-Term Follow-Up Results and Clinicoradiologic Factors for Successful Outcome. Am J Neuroradiol 2017; 38 (9): 1794–1798. Doi: 10.3174/ajnr.A5292.

8. Lee SJ, Ahn IM. Effectiveness of percutaneous ethanol injection therapy in benign nodular and cystic thyroid diseases: long-term follow-up experience. Endocr J 2005; 52 (4): 455–462. Doi: 10.1507/endocrj.52.455.

9. Cho YS, Lee HK, Ahn IM et al. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. Am J Roentgenol 2000; 174 (1): 213–216. Doi: 10.2214/ajr.174.1.1740213.

10. Sung JY, Baek JH, Kim YS et al. One-step ethanol ablation of viscous cystic thyroid nodules. Am J Roentgenol 2008; 191 (6): 1730–1733. Doi: 10.2214/AJR.08.1113.

11. Gharib H, Papini E, Paschke R et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for Clinical Practice for the Dia­gnosis and Management of Thyroid Nodules. Endocr Pract 2010; 16 Suppl 1: 1–43. Doi: 10.4158/10024.GL.

12. Kim JH. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck. Ultrasonography 2014; 33 (2): 83–90. Doi: 10.14366/usg.13026.

13. Brannan ZJ, Lubeley LJ, Sutphen SA et al. Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation. Pediatr Radiol 2019; 49 (6): 801–807. Doi: 10.1007/s00247-019-04356-x.

14. Zhao YF, Jia Y, Chen XM et al. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98 (3): 281–287. Doi: 10.1016/S1079210404000800.

15. Zhao YF, Jia J, Jia Y. Complications associated with surgical management of ranulas. J Oral Maxillofac Surg 2005; 63 (1): 51–54. Doi: 10.1016/j.joms.2004.02.018.

16. Rho MH, Kim DW, Kwon JS et al. OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. Am J Neuroradiol 2006; 27 (5): 1090–1095.

17. Roh JL. Primary treatment of ranula with intracystic injection of OK-432. Laryngoscope 2006; 116 (2): 169–172. Doi: 10.1097/01.mlg.0000191458.23867.88.

18. Kučerová J, Holý R, Kratochvílová B et al. Papilární karcinom v mediální krční cystě. Otorinolaryngol Foniatr 2015; 64 (4): 201–204.

19. Kim MG, Kim SG, Lee JH et al. The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts. Laryngoscope 2008; 118 (12): 2177–2181. Doi: 10.1097/ MLG.0b013e3181864acf.

20. Ohta N, Fukase S, Watanabe T et al. Treatment of thyroglossal duct cysts by OK-432. Laryngoscope 2012; 122 (1): 131–133. Doi: 10.1002/lary.22363.

21. Fukumoto K, Kojima T, Tomonari H et al. Ethanol injection sclerotherapy for Baker‘s cyst, thyroglossal duct cyst, and branchial cleft cyst. Ann Plast Surg 1994; 33 (6): 615–619. Doi: 10.1097/00000637-199412000-00009.

22. Ha EJ, Baek SM, Baek JH et al. Efficacy and safety of ethanol ablation for branchial cleft cysts. Am J Neuroradiol 2017; 38 (12): 2351–2356. Doi: 10.3174/ajnr.A5373.

23. Kim MG, Lee NH, Ban JH et al. Sclerotherapy of branchial cleft cysts using OK-432. Otolaryngol Head Neck Surg 2009; 141 (3): 329–334. Doi: 10.1016/j.otohns.2009.05.022

24. Yigit N, Karslioglu Y, Yildizoglu U et al. Dermoid cyst of the parotid gland: report of a rare entity with literature review. Head Neck Pathol 2015; 9 (2): 286–292. Doi: 10.1007/s12 105-014-0563-3.

25. Garcia-Rodriguez LR, Pawar S, Michel MA et al. A case of a dermoid cyst compressing the airway. WMJ 2012; 111 (6): 289–292.

26. Yasumoto M, Shibuya H, Gomi N et al. Ultrasonographic appearance of dermoid and epidermoid cysts in the head and neck. J Clin Ultrasound 1991; 19 (8): 455–461. Doi: 10.1002/jcu.1870190802.

27. National Cancer Institute [on-line]. Dostupné z: seer.cancer.gov/statfacts/html/oralcav.html.

28. Som PM. Detection of metastasis in cervical lymph nodes: CT and MR criteria and differential dia­gnosis. Am J Roentgenol 1992; 158 (5): 961–969. Doi: 10.2214/ajr.158.5.1566697.

29. Goyal N, Zacharia TT, Goldenberg D. Differentiation of branchial cleft cysts and malignant cystic adenopathy of pharyngeal origin. Am J Roentgenol 2012; 199 (2): W216–221. Doi: 10.2214/AJR.11.8120.

Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#