Reviewed on : 16 May 2019

Reviewed by : Rob Fontaine Coventry & Rugby CCG

Expires : 16 May 2021

Prior approval from the CCG will be required before any treatment proceeds in secondary care. 

Refer to Secondary Care provider via RSS using the appropriate Prior Approval Referral Form.

Ganglion

NO treatment unless causing pain or tingling / numbness or concern re diagnosis (worried it is a cancer);

• Aspiration if causing pain, tingling / numbness or concern re diagnosis
• Surgical excision ONLY considered if aspiration fails to resolve the pain or tingling/numbness and there is restricted hand function.

Seed ganglia that are painful:

• Puncture/aspirate the ganglion using a hypodermic needle
• Surgical excision ONLY considered if ganglion persists or recurs after puncture / aspiration.

Mucous cysts

NO surgery considered unless recurrent spontaneous discharge of fluid or significant nail deformity