• World Neurosurg · Dec 2019

    Long-Term Functional Outcome After Surgical Treatment of Peroneal Intraneural Ganglion Cyst.

    • Elena Lucattelli, Giulio Menichini, Mattia Brogi, Giuliana Roselli, and Marco Innocenti.
    • Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy. Electronic address: elena.lucattelli@gmail.com.
    • World Neurosurg. 2019 Dec 1; 132: e217-e222.

    BackgroundIntraneural ganglia are benign mucinous cystic formations that originate within the epineurium of peripheral nerves. Different treatments have been recommended, with an overall satisfactory outcome. In this paper, we aim to evaluate the long-term outcomes of surgical treatment of peroneal intraneural ganglia by reviewing our local institutional experience.MethodsWe performed a case series review of peroneal intraneural ganglia surgical treatment performed by the senior author. Demographic and surgical details were abstracted from the medical record for each patient. Electrodiagnostic studies and magnetic resonance imaging (MRI) were performed in all patients pre- and postoperatively.ResultsEight men were enrolled, with an average age at time of surgery of 47.5 years (range 28-68 years). Motor testing revealed a preoperative deficit of dorsiflexion, eversion, and toe extension in 7 patients, with a median preoperative Medical Research Council (MRC) score of 0/5. Sensory loss in the distribution of the common peroneal nerve was present in 7 patients. Mean clinical follow-up time was 113 months (range 32-189 months). Significant pain relief was achieved in all patients. Overall neurologic function was improved, more so for motor function. The median postoperative dorsiflexion, eversion, and toe extension at last follow-up were MRC score of 5/5. No complications occurred postoperatively. There was no clinical evidence of intraneural recurrence, as confirmed in postoperative MRI. In 2 patients, an extraneural cystic formation was visible in the anterior muscular compartment.ConclusionsThe data from our series support excellent long-term postoperative motor outcomes with a low recurrence rate. To avoid extraneural recurrence, resection of the superior tibiofibular joint is necessary.Copyright © 2019 Elsevier Inc. All rights reserved.

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