This is the incision and drainage of an infected cyst with packing. The packing could certainly be optional, in most cases, as studies show it isn’t necessary. I use it, in cases like these, where I’m worried about loculations and the anaesthesia isn’t great (because the field is infected) so breaking them down becomes problematic for the patient. On that note, I think it is worth noting that around the 4-5min point the patient describes ‘feeling’ me working and I should have addressed that more properly. I can explain, for a variety of reasons, why I know she was having more pressure than anything else, but it really doesn’t matter. She was apprehensive and I should have focused on that better. There is always something to learn, even for me.
The treatment was performed by oral and maxillofacial surgeons of our hospital. The patient was hospitalized for 3 days. The treatment included flushing the affected area with turpentine oil followed by the administration of local anesthesia and manual removal of maggots with tweezers.
Around 50–60 maggots were harvested. Teeth 12 and 21 were extracted. The area was then washed with saline, followed by irrigation with betadine. Broad spectrum antibiotics amoxycillin with clavaualnic acid and ibuprofen with paracetamol were prescribed. This procedure was repeated again until the maggots were completely removed. The next day the edema had subsided considerably. The parents were given extensive environmental and personal hygiene instructions. The maggots were sent to a Veterinary Parasitology Department in Chennai Veterinary College for identification.
Distinguish between cysts in the breast and tumors. Cysts can be in one or both breasts. Without a mammogram or needle biopsy it is almost impossible to distinguish between the two different types of lumps in the breast. Symptoms of a breast cyst will include:
Smooth, easily movable lump with distinct edges
Pain or tenderness over the lump
Size and tenderness will increase just before your period starts
Size and tenderness will decrease when your period ends
Understand cystic acne. Acne is a general term that describes a variety of different types of pimples, blackheads, pustules, whiteheads and cysts. Cystic acne are nodules that are red, raised, often 2–4 mm in size and nodular and are the most severe form of acne. The infection in a cystic acne is deeper than that in other pustules or whiteheads. Cystic acne is painful.
Identify a ganglion cyst. These are the most common types of lumps found on the hand and wrist. They are not cancerous and often harmless. Filled with fluid, they can quickly appear, disappear or change in size. They do not require treatment unless they interfere with function or are unacceptable in appearance.
Determine if pain is from a pilonidal cyst. In this condition there is a cyst, abscess or dimple that forms in the crease between the buttocks that runs from the lower end of the spine to the anus. It can be caused from wearing tight clothing, excess body hair, sitting for long periods of time or obesity. Symptoms can include pus from the area, tenderness over the cyst, or the skin may be warm, tender or swollen near the tailbone. Or there may not be any symptoms beside a pit or dimple at the base of the spine.
Distinguish a Bartholin gland cyst. These glands are located on either side of the vaginal opening to lubricate the vagina. When the gland becomes obstructed, a relatively painless swelling forms called a Bartholin’s cyst. If the cyst is not infected you may not notice it. An infection can occur in a matter of days causing tenderness, fever, discomfort walking, pain with intercourse, and a tender, painful lump near the vaginal opening.
See a doctor for swelling in the testicles. All testicular swelling must be diagnosed by a physician to determine the differences between a cyst, cancerous growth, hydrocele or infection in the testicles. A testicular cysts, also called a spermatocele or epididymal cyst, is typically a painless, fluid-filled, noncancerous sac in the scrotum above the testicles. T
Consider getting a second opinion if you are not satisfied with your physician’s diagnosis and treatment. Although most epidermoid and pilar cysts do not require treatment from a physician, if you do seek medical advice and are not satisfied with the results seek a second opinion. Most sebaceous and epidermoid cysts are straightforward, but there are other conditions that may mimic these cysts.
In a case study written in the Royal College of Surgeons of England, the authors presented two cases in which melanoma and a deep oral cavity were originally mistaken for a sebaceous cyst.
There are a variety of other infectious processes that may be mistaken for a sebaceous cyst, including boils, furuncles and carbuncles.
Treating a Cyst at Home
Treat uninfected epidermoid and sebaceous cysts at home. Signs of infection include the area becoming swollen, red, tender, or red and warm. If your home treatment for these cysts is not effective or if you experience symptoms, which indicate an infection, you should seek medical care from your physician.
If the cyst causes pain or discomfort with walking or intercourse, medical care is needed to treat the cyst.
Use a wet, warm compress over an epidermoid cyst to encourage it to drain and heal. The washcloth should be hot but not so hot that it burns the skin. Place it over the cyst two to three times a day.
Cystic acne responds better to ice than it does to heat.
Bartholin gland cysts can be treated at home using warm water sitz baths. This involves sitting in several inches of warm water to encourage the cyst to drain.
Refrain from picking, squeezing, or trying to pop either an epidermoid cyst or sebaceous cyst. This can increase the risk of infection and scarring. Also, never pick, squeeze or attempt to pop a cystic acne. This drives the infection deeper and increases the risk of scar tissue.