Management of intraneural fibro-lipoma of the median nerve and the role of Pressure-Specified Sensory Device (PSSD) for the patient's motor and sensorial evaluations.
OBJECTIVE
The intraneural fibro-lipoma is a benign, uncommon tumor which is     characterised with infiltration of the epineurium and perineurium by fibrofatty     tissue. The preoperative diagnosis is difficult. However, the Pressure-Specified     Sensory Device (PSSD) may support identifying the earliest stages of intraneural     fibro-lipoma when traditional electrodiagnostic testing will not be able to     detect a change in peripheral nerve function.


METHODS
Five     patients (3 male, 2 female, age 23-53; mean 41 years) with intraneural     fibro-lipoma were operated on. Grip strength, pinch strength and sensorial     functions were assessed in all patients before surgery and at the end of the     follow-up period by PSSD.


RESULTS
The patients were followed-up for 7 to 24     months (mean; 12 month). All patient's condition improved dramatically following     the operation and all patients had total relief of pain and paresthesia.


CONCLUSIONS
The decompression of intraneural fibro-lipoma of the nerve with     limited excision and epineurotomy without sacrificing the main nerve and its     branches is the ideal surgical procedure. We recommend the use of PSSD in the     investigation of patients with peripheral nerve compression, and chronic unusual     volar forearm and wrist swelling. PSSD is an important tool for pre-operative     evaluation and diagnosis of intraneural fibro-lipoma.
Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery and Burn Unit, Istanbul, Turkey.
Celalettin
C
Sever
Cihan
C
Sahın
Yalcın
Y
Bayram
Emin
E
Kapı
Yalcın
Y
Kulahcı
Ufuk
U
Berber
Mehmet
M
Incedayı
Fatih
F
Uygur
D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005350:Fibroma / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008067:Lipoma / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D020423:Median Neuropathy / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009460:Neurologic Examination / Q000295:instrumentation; D009463:Neuroma / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D011312:Pressure; D011984:Sensory Receptor Cells / Q000502:physiology; D055815:Young Adult