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What Is Pilonidal Cyst (Pilonidal Sinus)?

A pilonidal cyst is a disease that has been in people’s lives for a long time and it can negatively affect their lives.  The disease was introduced into the literature in 1833 by Herbert Mayo. The disease is known as a pilonidal cyst, pilonidal sinus, and sacral cyst.
 The disease was on the agenda during World War II.  The reason for this was determined that approximately 80,000 of the patients who applied to the health institutions at that time had pilonidal sinus. (1) It was found that the majority of these patients were jeep drivers.  Therefore, sacral cyst was called jeep disease at that time.  Why this problem that has more common among jeep drivers will be discussed later in this article

(1) Khanna, A., & Rombeau, J. L. (2011). Pilonidal disease. Clinics in colon and rectal surgery24(01), 046-053.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140333/

 What Is Pilonidal Cyst?

The disease is usually seen in the coccyx region.  But, it is rarely seen around the navel.
 Pilonidal sinus is the passing of substances such as hair and feathers that break from the body under the skin with the effect of friction.  The hairs that accumulate under the skin are trapped in a capsule to protect itself over time.  This capsule formed is called the pilonidal cyst.

 Why Does Pilonidal Cyst occur?

Pilonidal cyst means the nest of hair in Latin.  In other words, the cause of the problem is the accumulation of hairs under the skin.  Factors causing this situation can be listed as the following ;

  • Sitting for a long time
  •  Inadequate Hygiene
  •   Being Overweight
  •  Hair Loss (It is not right to say that hair loss causes hair to turn. But it is directly related to the disease)

Sitting for a long time increases the risk of Sacral Cyst.

 Hair that breaks from the head and back region directly fall into the hip, coccyx region.  Shedding hair and hairs under the skin with the effect of friction of the hips from the coccyx region.  Sitting for long hours increases this risk.  As mentioned in the introduction of the article, the disease is referred to as jeep disease in the literature.  The reason for this is that drivers sit and work for long hours.  Long-term sitting increases the risk of hair loss.

 Inadequate Hygiene causes Pilonidal Cyst.

The disease is not a matter of moment that the hairs pass under the skin in a short time.  The bristles must be in the coccyx area for a while to pass under the skin with friction.  During or after a bath. 
Frequent cleaning of the coccyx region prevents the hairs from sticking in the region, eliminating the risk of pilonidal sinus.

Being Overweight Causes Pilonidal Cyst.

Excess weight in all areas of life in the face of the negative adversely.  One of these areas is Pilonidal Cyst.  The risk ratio increases because the amount of friction in the hip part of the overweight individuals will be more.

Risk Groups of Pilonidal Sinus

 Scientific studies on hair rotation have reached the following data about risk groups;
 Hair rotation is 17 times more common in men.
 -The problem is most commonly observed in men aged 19-65 years.
 – The earliest was 19 years old in men and 21 years old in women.
 Ingrown hair in 88 people in a survey of 1,000 soldiers has been identified in Turkey.  It was found that 18 of 88 patients had hair rolling problems in their family members, 58 were long-distance drivers and 34 were overweight.

 What Are the Symptoms of Sacraln Cyst?

  • Bristle entry holes
  • Swelling
  •  Stream
  •  Abscess
  •  Pain

The first sign of the disease is hair entry holes that appear in the coccyx region.  It is not possible for the patient to notice these holes by himself.  But it can be noticed by someone else.

With the accumulation of hair under the skin, the capsule is formed and the capsule formed causes swelling and pain.

The body secretes a liquid to destroy the accumulated hair.  Unfortunately, this liquid is insufficient for hair removal.  In addition, secreted fluid discharge causes the complaint.  The liquid that cannot come under the skin in the form of discharge causes abscess formation.  Abscess formation causes pain.

The abscess may explode on its own.  Provides short-term relaxation, However, self-explosion of the abscess may cause skin damage.  Therefore, it should be emptied by the doctor instead of allowing it to explode on its own.  Hair loss treatment should be done after the abscess is evacuated. 

How is Pilonidal Sinus Treated?

 The treatment of the disease, which dates back to ancient times, has been tried with many different techniques.  However, many of these methods can be evaluated as outmoded or primitive in today’s conditions.  Bristle to date 50 different techniques has been tried.  Of these, Bascom, Karydakis, PitPicking, Primary Closure, Open Leave, Phenol and Flap applications are still used.  In addition, the most recently developed and used techniques are Micro Sinusectomy and Sinusotomy.  Micro Sinusectomy is the most advantageous among advanced therapies.

 What are the Advantages of Micro-Sinusectomy?  Why choose Micro Sinusectomy?

The aim of the treatment of hair rotation is to remove the hair from the body by opening the incision in the skin.  The hairs must be removed with the surrounding capsule.  Otherwise, complete treatment cannot be mentioned and the problem recurs in a very short time.

In some of the developed surgeries, a 20 cm incision is made.  This is quite arduous and leaves a mark.  However, micro sinusectomy is also the minimum incision.  Make a 2 * 2 incision and remove the hair rotation capsule from the body.  Due to its small incision, it can be applied under local anesthesia in a clinical setting.  In this way, there is no need for a hospital environment and hospitalization.  After treatment, the patient can return to social life on the same day.

Micro-sinusectomy technique can be performed with a minimum incision in as little as 5-10 minutes.  Therefore it would not make sense to choose other techniques with a lot of incisions and long healing process.

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