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Early Management in Extensive Cervical Cystic Hygroma and Macroglossia

AMA Arch Surg. 1960;80(3):460-463. doi:10.1001/archsurg.1960.01290200104018.
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A case of cystic hygroma will manifest itself as a mild or serious situation, depending upon the geographical extent of the lesion. The natural history of this disease is usually one of progressive growth. As described by Goetsch,1 the lesion tends to spread by a pseudopodic mechanism, pushing solid columns of endothelial cells around and through large and small structures, followed by channel formation resulting in a plexiform network formation of elongated and spheroidal cysts of various sizes. It is this progressive and insinuating growth with envelopment of vital structures that increases the hazard of surgery with the passage of time.

Some of the commoner clinical complications are obstruction to the upper respiratory and alimentary passages. This occurs not by compression alone but often, in addition, by formation of grape-like polypoid masses in the laryngopharynx and hypopharynx which obstruct these inlets. With macroglossia, food-taking is impaired or impossible, necessitating


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