Chen Yanhua, Ji Wei, Li Tao, Cong Xiaobin, Chen Zhenbing
Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2017 Aug;96(31):e7677. doi: 10.1097/MD.0000000000007677.
Treatment of carpal tunnel syndrome (CTS) remains a challenge for hand surgeons. Carpal tunnel release (CTR) using nasal instruments has the advantages of both endoscopy and open surgery. In this study we aimed to explore the effectiveness of CTR using nasal instruments in Chinese patients.We present a case series of 49 cases of idiopathic CTS treated with the mini-incision technique using nasal instruments. The average recovery days before return to normal work and complications were recorded. The mean grip strength, pinch strength, and sensation were evaluated. Subjective results were evaluated using the visual analogue scale (VAS), Levine Carpal Tunnel Syndrome Questionnaire (LCTSQ), Disabilities of the Arm, Shoulder, and Hand (DASH), and Medical Outcomes Study (MOS) 36-item short-form health survey (SF-36).The mean follow-up was 13 months. No return of symptoms or blood vessel injury occurred. The incidence of scar tenderness was only 8.1%, later pillar pain (after 4 weeks) was 18.4%, and average recovery time to return to normal work was 23.7 days. The mean grip strength, pinch strength, and sensation were significantly improved (P < .001). The VAS, LCTSQ, and DASH survey postoperative mean scores were lower than the preoperative scores (P < .001). SF-36 scores were significantly increased following surgery (P < .001).We conclude that the mini-incision technique for CTR using nasal instruments in Chinese patients is safe, effective, and low cost. It is worthwhile for the technique to be promoted and used.
腕管综合征（CTS）的治疗对手外科医生来说仍然是一项挑战。使用鼻内镜器械进行腕管松解术（CTR）兼具内镜手术和开放手术的优点。在本研究中，我们旨在探讨使用鼻内镜器械进行CTR在中国患者中的有效性。我们报告了一组采用鼻内镜器械小切口技术治疗的49例特发性CTS病例。记录恢复正常工作前的平均天数和并发症情况。评估平均握力、捏力和感觉功能。使用视觉模拟量表（VAS）、莱文腕管综合征问卷（LCTSQ）、上肢、肩部和手部功能障碍（DASH）以及医疗结局研究（MOS）36项简短健康调查（SF - 36）评估主观结果。平均随访时间为13个月。未出现症状复发或血管损伤。瘢痕压痛发生率仅为8.1%，术后4周后支柱痛发生率为18.4%，恢复正常工作的平均时间为23.7天。平均握力、捏力和感觉功能显著改善（P＜0.001）。VAS、LCTSQ和DASH调查术后平均得分低于术前得分（P＜0.001）。术后SF - 36得分显著提高（P＜0.001）。我们得出结论，在中国患者中使用鼻内镜器械进行CTR的小切口技术安全、有效且成本低。该技术值得推广应用。
