Neurologic Deficits after Surgical Enucleation of Schwannoma in the Upper Extremity
Journal of the Korean Society for Surgery of the Hand
;
: 41-48, 2017.
Article
in Korean
| WPRIM
| ID: wpr-162092
ABSTRACT
PURPOSE:
Neurologic deficits after enucleation of schwannoma are not rare. To evaluate the neurologic deficits after surgical enucleation of schwannoma in the upper extremity, we performed a retrospective review of patients with surgically treated schwannoma over a 14-year period at a single institution.METHODS:
Between March 2001 and September 2014, 103 patients underwent surgical enucleation for schwannomas; 36 patients of them had lesions in the upper extremity, and 2 out of 36 patients had multiple schwannomas. Each operation was performed by a single surgeon under loupe magnification. The postoperative neurological deficits were graded as major and minor in both immediate postoperatively and at last follow-up. The major deficit was defined as anesthesia or marked hypoesthesia, motor weakness of grade 3 or less and neuropathic pain. Minor deficit was defined as mild symptoms of mild hypoesthesia, paresthesia and motor weakness of grade 4 or more.RESULTS:
There were 2 major (2 mixed nerve) and 12 minor (4 motor, 7 sensory, 1 mixed nerve) neurologic deficits after surgery. At the last follow-up, one major mixed neurologic deficit remained as major motor and minor sensory, and other major ones changed to mixed minor. And all minor deficits except 1 sensory deficit were recovered spontaneously.CONCLUSION:
Even though high incidence rate of neurologic deficit after enucleation of schwannoma in the upper extremity (38.9%), about three fourths of them were recovered spontaneously. There were 3 permanent neurologic deficits, and one of them was major one. In some cases, surgeon cannot avoid to encounter a neurological deficit. So we recommend more delicate microscopic surgical procedure and preoperative planning and counseling. And surgery is indicated for only symptomatic lesions.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Paresthesia
/
Incidence
/
Retrospective Studies
/
Follow-Up Studies
/
Counseling
/
Upper Extremity
/
Hypesthesia
/
Anesthesia
/
Neuralgia
/
Neurilemmoma
Type of study:
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Society for Surgery of the Hand
Year:
2017
Type:
Article
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