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Pediatric surgical calendar

Pediatric surgical calendar

Process	Intervention age	Comments
Lingual frenulum	Neonatal >12 months (usually wait until 5 years)	With anesthesia (wait to assess pronunciation of the "R")
Labial frenulum	Once the permanent teeth have erupted	General anesthesia
Mucocele Ranula	Diagnosis Diagnosis	Most mucoceles tend to resolve spontaneously. Expectant management is advised. Excision if persistence or according to size.
Otoplasty	>6 años (8 - 10 años)	With acceptance of the child (and it is advisable to assess the psychological impact)
Preauricular tags*	At any age	Recommendation from 1 year of age. General anesthesia.
Preauricular fistulas* Preauricular sinus	1 year (if drainage, with suspicion of cyst or complication)	Better results if operated on before they become infected.
Branchial fistulas and cysts*	>3 years, if there is no clinic	Better results if operated on before they become infected.
Eyebrow tail cyst (Epidermoid cyst)	Recommended >1 year
Thyroglossal duct cyst	Diagnosis	To avoid superinfection and fistulization.
Cleft lip	3 - 6 months	Variable depending on the type of cleft and technique used.
Cleft palate	9 - 18 months	Variable depending on the type of cleft and technique used.

* Non-routine renal ultrasound (only in suspected syndromic process)

Process	Intervention age	Comments
Pectus excavatum and carinatum	>12 years recommended	Consider orthopedic treatment at any age.
Polythelia	>10 years if local anesthesia is considered	If they are minimal, they can be left. In girls with breast tissue or areola, intervention.
Epigastric hernia	>3 years	They do not resolve spontaneously.
Umbilical hernia	>3 years	Most resolve spontaneously
Dermoid Navels: Granulomas	Diagnosis	If treatment with Silver Nitrate fails
Dermoid Navels: Cysts	Diagnosis (>3 years)
Dermoid Navels: Urachal rests	Diagnosis (>3 years)	Prior treatment depending on size or symptoms (omphalomesenteric, patent urachus, cysts...)
Diastasis rectis	Does not require surgery

Process	Intervention age	Comments
Phimosis	>5 years. Initially, treatment with corticosteroid ointment.	Diagnosis in: Balanitis xerotica obliterans, paraphimosis, obstructive uropathies, recurrent infections...
Short preputial frenulum	Only if the child has symptoms.	Preferably local anesthesia, from the age of collaboration.
Hypospadias	12 - 24 months	It depends on the type and surgical technique.
Congenital hydrocele	>3 years	Surgical criteria: - Patent peritoneovaginal communication >3 years. - Non-communicating hydrocele under tension, with pain.
Cord cyst/Nuck cyst	Same as hydrocele.	The same criteria.
Acquired hidrocele	Diagnosis
Inguinal hernia	Diagnosis	Greater risk of incarceration the younger the child.
Cryptorchidism	From 1 year.
Varicocele	See comments	Whenever there is a decrease in testicular volume. If it is only a high degree, the benefit is doubtful.
Epididymal cyst	Spontaneous resolution.	Only treat if pain or increase in size.
Vulvar synechiae Imperforate hymen	Diagnosis	Vulvar synechiae: it can be done in the office with topical anesthesia depending on the age and cooperation of the girl. If not, in the operating room with general anesthesia.

Process	Intervention age	Comments
Ingrown toenail	Diagnosis	If conservative treatment fails. They are usually teenagers. Not indicated in neonates and infants. Assess with local anesthesia.
Spring finger	Diagnosis
Polydactyly	Pediculated: Neonatal. Not pedunculated from one year of age.	Local anesthesia. General anesthesia.
Syndactyly	2 years. 1 year in hand	Before, if they affect the thumb clamp.

Process	Intervention age	Comments
Pilomatrixoma	Diagnosis	Consider local anesthesia, and preferably >3 years.
Dermoid cysts	Diagnosis	Consider local anesthesia, and preferably >3 years.
Palmar Hyperhidrosis	School age.	If conservative treatment fails. In adolescence.