Bucher Florian, Maerz Vincent, Obed Doha, Vogt Peter M, Weyand Birgit
Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
Medizinische Hochschule Hannover - Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Hannover, Germany.
European J Pediatr Surg Rep. 2022 Mar 10;10(1):e33-e36. doi: 10.1055/s-0042-1742608. eCollection 2022 Jan.
Intraneural ganglia are benign mucinous cysts located within the epineurium of a peripheral nerve. The pathogenesis and formation of intraneural ganglia are controversial. The main theories described in the literature are of degenerative, synovial or de novo occurrence. We present the case of a 14-year-old boy who presented in our outpatient clinic with a complaint of interdigital neuralgia between hallux and second toe, as well as left foot drop. MRI examination showed a hyperintense cystic distension of the common peroneal nerve measuring 130 mm × 5 mm extending from the poplitea to the anterior compartment of the leg. We performed microscopic decompression and neurolysis surgery. The cyst showed a sac-like distension at its distal end with connection to the tibiofibular joint and was resected. After 8 weeks, postoperatively, the boy claimed to be pain-free and slight recovery of the superficial peroneal nerve was noticed. At 6 months postoperative, the patient showed a continuous improvement of motor function, demonstrating foot eversion with 3/5 muscle strength and foot extension with 2/5 muscle strength. Intraneural ganglia reported for pediatric patients represent a very rare entity. To the best of our knowledge, less than 15 cases have been described within the English-speaking literature.
神经内神经节是位于周围神经外膜内的良性黏液囊肿。神经内神经节的发病机制和形成存在争议。文献中描述的主要理论有退行性、滑膜性或新生性。我们报告了一例14岁男孩的病例，他因拇趾与第二趾间的指神经痛以及左脚下垂前来我们门诊就诊。MRI检查显示腓总神经有一个130毫米×5毫米的高强度囊性扩张，从腘窝延伸至小腿前侧间隙。我们进行了显微减压和神经松解手术。囊肿在其远端呈囊状扩张，与胫腓关节相连，予以切除。术后8周，男孩称已无疼痛，且腓浅神经有轻微恢复。术后6个月，患者运动功能持续改善，足背屈肌力为3/5，足背伸肌力为2/5。报道的小儿神经内神经节病例非常罕见。据我们所知，英文文献中描述的病例不到15例。
