Comparative Study of Recurrence and Complications Using Various Sclerosants by Single Dart Technique in Treatment of Ganglion Cysts

Abstract

Ganglion cysts are tense,smooth,fluctuant,cystic and transilluminant swellings. They are commonly found on the dorsum of the wrist, at the scapholunate articulation and may involve volar wrist, tendon sheaths and even inter phalangeal joints. This study aims to compare the efficacy and the recurrence rates with triamcinolone, hyaluronidase and sodium tetradecyl sulphate,using the single dart technique. This prospective observational study was conducted on patients who presented to the general surgery outpatient department of our institute with ganglion cysts of wrist between January 2010 and August 2011 (20 months). A total of 180 patients were included in this study. The difference in the recurrence rates after sclerotherapy for ganglion cysts is statistically not significant between triamcinolone and hyaluronidase regimens as Z (P1-P2)01.70, p>0.05 but the difference in the recurrence rates after sclerotherapy for ganglion cysts is statistically significant between triamcinolone and sodium tetradecyl sulphate regimens as Z (P1-P2)03.34, p<0.05 . Chi-square value −10.33 (2°of freedom), p00.00571987 (significant at 5 % level). Intralesional injection of triamcinolone by single dart technique, therefore, may be considered as a simple, safe, cost effective, convenient, less invasive alternative to surgical excision of wrist ganglion cysts.

Chemical Substances Used in the Treatment of Ganglions Located in the Hand and Wrist

“…In this study no adverse effects, including skin hypopigmentation, were observed after administration of triamcinolone [17]. This was in contrast to the aforementioned study by Chatterjee et al [10], who reported hypopigmentation in five out of 60 patients (8.3%) who were treated with triamcinolone.…”

“…In the hyaluronidase group, two patients (3.33%) developed a hypersensitivity reaction, and in one patient (1.67%) hyaluronidase administration caused skin ulceration at the injection site. Hypopigmentation of the skin was not observed in any of the patients [10].…”

“…Unlike all of the above-cited studies, in which hyaluronidase administration preceded ganglion aspiration, in the clinical trial conducted by Chatterjee et al [10], hyaluronidase, triamcinolone or sodium tetradecyl sulfate were injected after aspiration. The study group consisted of 180 patients, divided into three subgroups of 60 patients each.…”

“…Moreover, the authors emphasized the possible risk connected with inadvertent injection of this agent into a tendon or a joint [20]. Chatterjee et al [10] observed hypersensitivity to sodium tetradecyl sulfate in four of their 60 patients (6.66%) and the presence of skin ulcerations in three (5%).…”

Comparative Study of Recurrence and Complications Using Various Sclerosants by Single Dart Technique in Treatment of Ganglion Cysts

“…Sir, We read with a lot of interest the article published in your esteemed journal titled BComparative study of recurrence and complications using various sclerosants by single dart technique in treatment of ganglion cysts^ [1]. We would like to congratulate the authors for the excellent results with minimal recurrence rate.…”