Pressure Measurement in Carpal Tunnel Syndrome : Correlation with Electrodiagnostic and Ultrasonographic Findings

OBJECTIVE: This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). METHODS: CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. RESULTS: Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was 56.7 +/- 19.3 mmHg (Mean +/- SD) and 7.4 +/- 3.3 mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. CONCLUSION: CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.

The Cubital Tunnel Syndrome with Medial Ganglion Cyst

The association of medial elbow ganglion cyst with cubital tunnel syndrome has been rarely reported. A 61-year-old man presented with progressive right hypothenar atrophy and paresthesia for 7 months. Ultrasonography and magnetic resonance imaging revealed ulnar nerve entrapment with a cystic ganglion in cubital tunnel. Decompression of ulnar nerve and excision of the ganglion were performed. Motor function of the ulnar nerve showed an improvement four months later after surgery. Because most ganglia are occult, imaging study is warranted especially in case with osteoarthritis. Excision of the ganglion performed concurrently with decompression of the ulnar nerve provide satisfactory results.