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Mucous Cyst Excision 26160

Mucous cyst clinical photo

Mucous cyst xray

Mucous cyst lateral view xay

CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:mucous cyst excision, ganglion cyst excision, resection, removal

Mucous Cyst Excision CPT

Indications

  • pain
  • recurrent infection
  • chronic drainage
  • cosmesis

Mucous Cyst Excision Contraindications

Mucous Cyst Excision Alternatives

  • Aspiration

Mucous Cyst Excision Pre-op Planning

  • Consider if skin graft will be require and consent for graft if needed.  
  • Consider DIP arthrodesis if underlying arthritis is severe.

Mucous Cyst Excision Technique

  • Preop antibiotics
  • Sign operative site
  • Digital block anesthesia
  • H, T, U, or transverse curving incision shape, depending on skin integrity and cyst size and location
  • Dissection carried down under 2.5x loop magnification
  • Avoid injury to extensor tendon, nail matrix, articular surface, terminal NV bundle. 
  • Perform synovectomy, osteophyte resection, and debridement
  • Repair terminal extensor tendon if disrupted   repaired to prevent subsequent extensor lag
  • Closure:  skin graft, a rotational flap, or primary closure 

Mucous Cyst Excision Complications

  • Extensor tendon rupture / lag
  • Recurrence
  • Incomplete relief of pain
  • Nonuion
  • Infection
  • Painful hardware
  • Nail deformity
  • Stiffness

Mucous Cyst Excision Follow-up care

  • Post-op: place in extension splint, STAXX splint if extensor tendon repair required or skin graft used.   Early motion otherwise
  • 7-10 Days: wound check.  Staxx splint if extensor tendon repair, early ROM otherwise.

Mucous Cyst Excision Outcomes

  • 3-15% recurrence rate
  • Continued nail defomity is not uncommon

Mucous Cyst Excision Review References

  • Thornburg LE. Ganglions of the hand and wrist. JAAOS. 1999;7:231-8. 
  • Budoff JE. Mucous Cysts. J Hand Surg Am 2010;35:828
  • Kasdan ML, Stallings SP, Leis VM. Outcome of surgically treated mucous cysts of the hand. J Hand Surg Am 1994;19:504.
  • Shin EK, Jupiter JB. Flap advancement coverage after excision of large mucous cysts. Tech Hand Up Extrem Surg. 2007;11:159.