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Benign cystic head and neck lesions have traditionally been managed conservatively or with surgical excision. Ethanol ablation (EA) has now established a role in the management of benign thyroid cysts, and its use has also been expanded to non-thyroid cysts. This paper reports on the outcomes of 25 patients treated with EA for a number of different cystic neck lesions. The most common lesions were thyroglossal duct cysts (n=8, 32%) followed by lymphoepithelial parotid cysts (n=7, 28%). Cyst volume was measured by ultrasound before and after intervention, with treatment success defined by >70% volume reduction or resolution of symptoms. In terms of technique, an 18-gauge needle was used to aspirate the cyst contents, prior to injecting half the volume of cyst aspirate with 97% sterile ethanol. The area was then massaged, and a compressive dressing placed over the injection site. Patients were followed up at one and three months. After one EA session, the mean reduction in cyst volume was 74%. Overall, the treatment success rate was reported to be 92%. No complications were recorded, and patient satisfaction was 100%. Considering the significant waiting list backlog for routine surgery due to the effects of the coronavirus pandemic, as well as the very low complication rate associated with EA relative to surgery, now seems the ideal time to incorporate EA more widely in the treatment of suitable cystic neck lesions.

Efficacy of ethanol ablation as a treatment of benign head and neck cystic lesions.
Lee E, Park I, Elzomor A, et al.
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Christopher Burgess

Musgrove Park Hospital, Taunton, UK.

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