Turkish Neurosurgery 2013 , Vol 23 , Num 1
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
Celalettin Sever1, Cihan Sahın1, Yalcın Bayram2, Emin Kapı3, Yalcın Kulahcı1, Ufuk Berber4, Mehmet Incedayı5, Fatih Uygur1
1Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery and Burn Unit, Istanbul, Turkey
2Maresal Cakmak Military Hospital, Department of Plastic and Reconstructive Surgery, Erzurum, Turkey
3Sırnak State Hospital, Department of Plastic and Reconstructive Surgery, Sırnak, Turkey
4Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Pathology, Istanbul, Turkey
5Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Radiology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.6106-12.0 AIM: 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.

MATERIAL and 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.

CONCLUSION: 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. Keywords : Pressure-specified sensory device ( PSSD), Intraneural fibro-lipoma, Fatty infiltration

Corresponding author : Celalettin Sever, drcsever@hotmail.com