Microsurgical open mini uniskin incision technique in the surgical treatment of carpal tunnel syndrome.

BACKGROUND: Patients who undergo carpal tunnel surgery sometimes complain of the restriction of the grip and pinch function, palmar tenderness, cosmetic problems, and scar formation at the site of the incision. AIMS: We used a modified mini uni-skin incision with appropriate hand position for microscopic view in the surgical treatment of carpal tunnel syndrome to prevent cosmetic problems related with scar formation after surgery. SETTINGS AND DESIGN: In this study we used two different skin incision techniques; mini uni-skin incision and standard incision. In mini uni-skin incision technique the hands were positioned in a way that the wrist are hyperextended. A small skin incision one cm long was done from the inferior flexion crease towards the point between the thirth and fourth fingers. MATERIALS AND METHODS: Standard incision and mini uni-skin incision were compared according to their cosmetic result, grip and pinch function, palmar tenderness, and painful scar formation. STATISTICAL ANALYSIS: Student -t test was used for this study. RESULTS: 56 (43%) patients were operated with mini uni-skin incision, and 73 (57%) cases were operated with standard incision. The scores of grip, pinch and cosmetic results were better in the patients who were operated with mini uni-skin incision technique from those of standard incision. CONCLUSION: In this clinical study we used a modified skin incision (mini uni-skin incision) technique in the surgical treatment of carpal tunnel surgery. Our results revealed that mini uni-skin incision is superior from the standard incision.

Intraoperative ultrasonographic characteristics of malignant intracranial lesions.

AIMS: The aim of this study was to evaluate the capability of intraoperative ultrasonography (IOUSG) in identifying malignant intraparenchymal tumors during surgical intervention. SETTINGS AND DESIGN: Forty patients with intrinsic malignant tumors were evaluated by using IOUSG. MATERIALS AND METHODS: A real-time ultrasound scanner with a 3- or 5-MHz transducer was used for this study in all cases. The tip of the ultrasound probe was placed on the intact cranial dura mater and then moved in the sagittal and coronal planes. RESULTS: Nineteen of forty patients had lesions that were primary malignant glial tumors. Five of them had previous surgery and radiotherapy. The remaining twenty-one had metastatic tumors. All lesions were well localized and malignant characteristics were well defined by IOUSG. Radiation-induced changes in five lesions in the surrounding brain and tumor parenchyma were described. CONCLUSION: In conclusion, IOUSG is not only helpful in localizing lesions but it can also be used in determining the malignant characteristics of lesions.