Cystic hygroma of the neck

The literature is reviewed. Forty-four cases of cystic hygroma of the neck are reviewed. Obstruction to the respiratory and alimentary passages was always associated with extension of the hygroma to the mediastinum or floor of the mouth, and extension to the mediastinum was found only in lesions on the right side of the neck. Spontaneous resolution occurred in seven cases, regression began early and was complete in most of these cases by the age of 2 years. Episodes of infection did not appear to lead to any appreciable regression in twelve cases exhibiting this complication. One case, however, resolved completely after incision and drainage of the infected cyst. Aspiration is recommended as an emergency measure to relieve excessive tension and as a diagnostic procedure when infection is suspected. Injection of sclerosing solutions is of little value, as no cases were cured by this treatment, and subsequent excision was probably made more difficult by the resulting fibrosis. Surgical excision is the treatment of choice. If possible this should be total, but partial excision is recommended when total resection would jeopardise vital structures. There were no recurrences following total excision in nine cases. Of the twenty-three cases where the resection was partial, thirteen have remained free from recurrence for periods ranging from eighteen months to sixteen years. Radiotherapy, because of such serious complications as radionecrosis and permanent damage to growing tissues, is not recommended for the treatment of cystic hygroma.