GANGLION CYST

The ganglion cyst is a benign lesion which arises either through the tendon sheath of one of the tendons of the foot (common extensor tendons of the toes), or is a synovial protrusion one of many joints are at the foot.

Clear etiology which creating a ganglion cyst is not fully clarified.

Εtiology

Justified the severe fatigue of the foot - long hours walking on ramps or stairs, but most of the time can not isolate the factor responsible. Heredity may play a role because ganglia (ganglionic cysts) often identified and other individuals in the family.

Symptoms

The ganglion cyst is usually a cosmetic problem rather than functional (does not cause pain).
Sometimes it can cause pain when the size is quite large or is in connection with nerve where creates locally pressing phenomena.

This results in addition to the existence of pain, appear and tingling feeling (numbness) in the dorsal surface of the foot and heartburn that may radiate to the toes or in the ankle joint. Especially when the person again closed shoes and pressed the ganglion cyst then may display intense local pain which forces the patient to stop physical activity.
 

CONSERVATIVE TREATMENT
THERAPY: 

The ganglion cyst -ganglio-, can present exacerbation and remission phenomena. Can that be swell at times and calm at other times.

Conservative treatment includes percutaneous drainage ganglion with needle, if it is feasible due to the viscous nature of the transparent gel lying within the ganglion cyst, and simultaneous injection of local cortisone.

Usually ganglion recurs immediately and the result is the definitive treatment of a cyst that causes symptoms is the microsurgical removal. The foot rest which can generally help in remission.

OPERATIVE TREATMENT
THERAPY: 

The microsurgical removal of ganglion cyst is usually the final solution. The operation is performed with femoral block, epidural or general anesthesia and not local anesthesia because if the ganglion emerges from the joint (synovial bursa), the local anesthesia will be inadequate.
Orthopaedic surgeon remove the cyst from the emerging point -joint-, and suture this point permanently to avoid the possibility of ganglion recurrence.


Ganglion on the dorsal surface of the foot (arrow).  A patient walking many kilometers per day for professional reasons


The designed skin area highlights the shape and size of the ganglion


Generously sized ganglion cyst in the dorsal and lateral aspect of the foot. Cyst that causes severe pain to the patient because it comes in full contact and pressure on nerve


The ganglion was removed by microsurgical technique. The arrow indicates the nerve which strongly pressed from the ganglion cyst causing pain, numbness and tingling sensation not only locally but with reflection in the toes and ankle


The ganglion after removal. On the inside is filled with a transparent gel

After the end of the operation which lasts from 20-35 minutes, the patient remains in the clinic for 2-3 hours depending on the type of anesthesia that has been received. The walking and driving can be made the next day. The patient returns to his activities very quickly. Pain, numbness and burning pain subside immediately after surgery and the patient is relief from the symptoms.
The stitches are removed 8-10 postoperatively.