I have carpal tunnel and ganglion cyst. do i need surgery?

Yes: If the cyst in is the carpal tunnel. If not, try splinting and lifestyle modification first.

If bad, yes: If these are minor and not causing you too much trouble, and feel better using a brace, then "no". Keep in mind the cyst won't really go away, but it's ok to live with a cyst. If you want these things to be "cured" or gone, or they are giving you significant troubles, then "yes". Surgery will fix these nicely.

Depends: Carpal tunnel can cause symptoms of pain and tingling that can affect hand function, ganglions can cause pain with wrist movement and affect range of motion. If either causes loss of function and/or pain then surgery would be an option.

Possibly.: Ganglion cysts are usually a nuisance and often do not require surgery. Carpal tunnel syndrome, however, can sometimes lead to permanent nerve damage if not treated.

Both depend : On severity and most of the time does not require surgery. I would advise to be eval by rheumatologist or hand surgeon first and decide if conservative ( wrist splint, medicine, physical therapy, injection) vs surgery.