Ganglion cysts, which account for 50–70 percent of tumors in the hand and wrist regions, are one of the most prevalent benign soft tissue tumors [2, 10]. There are several ways to treat ganglions, including aspiration, sclerotherapy, intralesional steroid injection, and surgical removal; however, none of these approaches have proven to be the single most effective treatment. Consequently, there is no gold standard for treatment. When our patients first presented, their average age was 30.16 ± 13.01 years (p = 0.012). Our results were consistent with those reported by Singhal et al.. The findings are similar, while in research by Paul and Sochart, the mean age was 40.25 years [11, 12].
There were 54 patients in our research and a male: female ratio was found to be 1:1.35. Comparable outcomes were attained in the West with a ratio of 1:1.3 [13]. A ratio of 1:1.4 was recorded in several studies pertaining to African and European demographic groupings [14, 15]. Recurrence is the most frequent side effect of ganglion cysts. To treat wrist ganglions, Paramhans et al. examined two techniques: aspiration followed by triamcinolone injection and surgical removal. They concluded that intracystic steroid injection was a safe course of therapy after discovering recurrence rates of 8.4% and 21.5% [16]. The claim that women have a higher incidence of ganglion cysts than males is supported by the results of every study, which consistently demonstrate that women have a higher prevalence of ganglion cysts. This link bolsters the idea that, as research now in publication suggests, ganglion cysts may be more frequent in women [17]. Similar to our study, preoperative discomfort was noted to be common in all patients in the study by Turgut et al. However, after the procedure, this drastically declined, with only 2.7% of the patients experiencing discomfort at the 12-month check-up. Similarly, 9.5% of patients reported feeling numb prior to the procedure; this number steadily dropped following the procedure, reaching 1.4% at the 6- and 12-month follow-ups, and our results were comparable to this [20].
Swelling was the most frequently reported symptom among the patients in our study, affecting all the patients in the study group. Approximately 59.3% of patients reported having pain or discomfort, while 11.1% reported having lost sensations, such as temperature, fine and crude touch, vibration, and pressure. 18.5% of patients reported having concerns regarding the existence of tumors, whereas 27.7% of patients expressed concerns about cosmetic issues. We also analyzed the prevalence of various comorbidities among the patients, and only 24 out of the 54 patients had comorbidities, among which hypothyroidism was the most prevalent (37.5%), followed by diabetes mellitus (33.3%), and systemic hypertension (25%); however, the difference was not statistically significant (p = 0.683). We also correlated age with the MSTS score and the rate of recurrence, which was well correlated and statistically significant.
We examined two treatment approaches in our study: aspiration combined with steroid injection, and surgical excision. Compared with aspiration and injection (success rate of 64.3% and recurrence rate of 35.7%), surgical excision has a much higher success rate (92.5%) and a lower recurrence rate (7.5%). These data unequivocally demonstrate the superiority of surgical excision. Our outcomes were comparable to those attained by Humail et al., in which dorsal wrist ganglions were treated, and they observed a recurrence rate of 24% following surgical excision and 43% following aspiration and steroid injection. According to a study by Jagers et al. on 100 wrist ganglions, patients treated with aspiration followed by hyaluronidase injection had a recurrence rate of 77%, while those who underwent surgery had a recurrence rate of 24% with a follow-up period of one year [18,19].
It is probable that the findings of this study cannot be extended to other populations or situations because only one center was used. As healthcare institutions vary in terms of patient demographics, clinical practices, and available resources, the results may vary. The inclusion criteria of the study may have unintentionally generated selection bias because people with specific features or co-occurring conditions may be more likely to meet the requirements. Future research should focus on refining treatment protocols, exploring potential risk factors for recurrence, and investigating long-term outcomes of different treatment modalities. Additionally, studies on the potential use of adjunctive therapies or alternative minimally invasive techniques may provide valuable insights into optimizing the management of ganglion cysts.