Sanger J R, Matloub H S, Yousif N J, Komorowski R
Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee.
Plast Reconstr Surg. 1992 May;89(5):949-52. doi: 10.1097/00006534-199205000-00029.
Following rupture of a subpectoral breast prosthesis, massive amounts of silicone gel migrated into the arm of a patient. The patient developed painful paresthesias and decreased sensation in the cutaneous distribution of the superficial radial nerve. Nerve conduction studies showed both an increase in distal latency and decreased amplitude in this nerve compared with the normal opposite side. Subsequent neurolysis confirmed dense fibrosis surrounding the nerve. Silicone droplets also were observed within the thickened epineurium of the median nerve, but no electrophysiologic evidence of neuropathy occurred. Multiple debridements of the subcutaneous tissue of the arm were necessary. In one of these specimens, histologic sections demonstrated silicone gel infiltration of a subcutaneous nerve. This is the first reported case of silicone gel infiltration of a nerve and constrictive neuropathy associated with a prosthesis rupture.
一名患者的胸肌下乳房假体破裂后，大量硅胶凝胶迁移至其手臂。患者出现疼痛性感觉异常，桡神经浅支皮区感觉减退。神经传导研究显示，与对侧正常神经相比，该神经的远端潜伏期延长且波幅降低。随后的神经松解术证实神经周围存在致密纤维化。在正中神经增厚的神经外膜内也观察到硅胶液滴，但未出现神经病变的电生理证据。手臂皮下组织需要多次清创。在其中一个标本的组织学切片中，可见皮下神经有硅胶凝胶浸润。这是首例报道的硅胶凝胶浸润神经及与假体破裂相关的压迫性神经病变病例。
