Excision of left neck mass with layered plastic surgical closure.

PREOPERATIVE DIAGNOSIS:  Left neck mass.

POSTOPERATIVE DIAGNOSIS:  Left neck mass.

PROCEDURE:  Excision of left neck mass with layered plastic surgical closure.

ANESTHESIA:  General.

COMPLICATIONS:  None.

ESTIMATED BLOOD LOSS:  Minimal.

PROCEDURE IN DETAIL:  The patient was taken to the operating room and placed supine on the operating table.  General anesthesia was induced via a laryngeal mask airway.  The left neck mass was palpated and the superficial skin overt was injected with 1% lidocaine with 1:100,000 epinephrine.  The patient was then prepped and draped in a standard fashion and 10 minutes were allowed for the local anesthetic to take maximal effect.  A #15 blade was used to incise the skin medially over the mass.  A sharp dissection was carried through the iris scissors until the apex of the cystic mass was identified.  The cystic mass was then carefully circumferentially dissected using blunt scissors.  ____ stalk that was present. This was obliterated with the electrocautery.  ____ appeared consistent with a larger sebaceous cyst.  The entire cyst was removed on block and sent to Pathology as a specimen.  Then, the wound was copiously irrigated.  Superior and inferior based flaps were then undermined.  The inferior aspect of the wound was closed with 4-0 chromic, and care taken to ensure to obliterate the dead space.  The skin was then closed with the combination of 5-0 nylon subcuticular sutures and some 5-0 simple sutures.  A sterile dressing was then applied.  The patient arouse from anesthesia and taken back to the recovery room in stable condition.