Percutaneous image-guided cryoablation of peripheral neuroma for chronic pain Percutaneous image-guided cryoablation of peripheral neuroma for chronic pain Interventional procedures guidance Published: 4 January 2023 www.nice.org.uk/guidance/ipg747 Your responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising of peripheral neuroma for chronic pain is inadequate in quality and quantity. Therefore, this procedure should only be used in the context of research. Find out what only in research means on the NICE interventional procedures guidance page. 1.2 For Morton's neuroma, further research should preferably be in the form of randomised controlled trials and should report details of patient selection
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Ultrasound-guided infiltration with hyaluronic acid compared with corticosteroid for the treatment of Morton's neuroma A local injection may be used as an early option in the treatment of Morton's neuroma, and can be performed using various medications. The aim of this study was to compare the effects of injections of hyaluronic acid compared with corticosteroid in the treatment (six feet) (25.0%) in the corticosteroid group, all with discolouration of the skin at the site of the injection. These minor complications might have been due to the three weekly injections of a relatively high dose of corticosteroid. No patient subsequently underwent excision of the neuroma. An ultrasound-guided corticosteroid injection showed statistically significantly better functional and pain
Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor management. Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor (CoGNET), previously called ampullary gangliocytic paragangliomas (GP) are a rare entity, with only few reported cases in the literature. This is a multicentric retrospective cohort of patients treated with endoscopy or surgery for ampullary CoGNET
Traumatic Versus Nontraumatic Hand Digit Amputations: Neuroma Risk, Prevention Success, and Predictive Factors. Digital amputations can occur following trauma for a variety of reasons. The objective of the study was to evaluate the difference in neuroma rates between elective and emergent digital amputations and the factors contributing to persistent pain following amputation. A retrospective elective procedures (n = 401) exhibited a neuroma rate of 4%, whereas those who underwent emergent surgeries (n = 506) had a neuroma rate of 3.2%. Patients were predominantly male (74%) with an average age of 52 years. Comorbidities were more frequent in patients who underwent elective surgeries. One hundred eleven patients had severe stump pain affecting their day-to-day lives, of which 32 (female, 28
Startle sign events induced by mechanical manipulation during surgery for neuroma localization: a retrospective cohort study. Chronic pain from peripheral neuromas is difficult to manage and often requires surgical excision, though intraoperative identification of neuromas can be challenging due to anatomical ambiguity. Mechanical manipulation of the neuroma during surgery can elicit a characteristic "startle sign", which can help guide surgical management. However, it is unknown how anesthetic management affects detection of the startle sign. We performed a retrospective cohort study of 73 neuroma excision surgeries performed recently at Massachusetts General Hospital. Physiological changes in the anesthetic record were analyzed to identify associations with a startle sign event. Anesthesia
Individual- and Community-Level Social Determinant Associations With Acoustic Neuroma Disparities in the United States. This investigation aims to determine whether community-level social determinants of health (SDoH) influenced acoustic neuroma outcomes more profoundly than individual-level SDoH through the use of multivariate models and census-level socioeconomic status (SES) measures . Observational, retrospective cohort study. Setting: Specially Authorized Head-Neck SEER 2020 Dataset. 23,330 adult (20+ yr) patients diagnosed with acoustic neuroma from 2010 to 2018. Age-adjusted multivariate regressions and hazard models were performed for individual level (sex, race-ethnicity) and community-level factors (Yost Index-SES, rurality-urbanicity) to assess for differences in acoustic neuroma
Acoustic neuroma Vestibular schwannoma - Symptoms, diagnosis and treatment | BMJ Best PracticeSkip to main contentSkip to search * About us * Help * Subscribe * Access through your institution * Log inBMJ Best Practice * Help * Getting started * FAQs * Contact us * Recent updates * Specialties * Calculators * Patient leaflets * Videos * Evidence * Drugs * Recent updates /pubmed/9592666?tool=bestpractice.com[2]Jones KD. Summary: vestibular schwannoma (acoustic neuroma) consensus development conference. Neurosurgery. 1993 May;32(5):878-9.http://www.ncbi.nlm.nih.gov/pubmed/8492871?tool=bestpractice.com Vestibular schwannomas are also called acoustic neuromas, and the two terms may be used interchangeably. However, acoustic neuroma is a misnomer, because the tumour
Prominent corneal nerves in pure mucosal neuroma syndrome, a clinical phenotype distinct from multiple endocrine neoplasia type 2B. Pure mucosal neuroma syndrome (MNS), an autosomal dominant neurocutaneous disorder, is a rare discrete subgroup in multiple endocrine neoplasia (MEN) type 2B, which present without associated endocrinopathies of MEN2B but with typical physical features such as prominent corneal nerves. Case presentation This report describes a 41-year-old patient with complaint of itchy eyes and irritation, presenting with blocked gland orifices in the upper and lower eyelids, light conjunctival hyperemia, a semitransparent neoplasm measuring 2 mm*2 mm on the nasal limbus suggestive of neuromas, and prominent corneal nerves. In vivo confocal microscopy (IVCM) revealed
Epidemiology, risk factors, diagnosis, and treatment of intra-abdominal traumatic neuromas - a narrative review. Traumatic neuroma (TN) is a disorganized proliferation of injured nerves arising from the axons and Schwann cells. Although TN rarely occurs in the abdominal cavity, the incidence of TN may be underestimated because of the large number of asymptomatic patients. TN can cause persistent
Retracted: Analysis of Related Factors Affecting Facial Nerve Function after Acoustic Neuroma Surgery. [This retracts the article DOI: 10.1155/2022/5194566.].
Biology and pathophysiology of symptomatic neuromas. Neuromas are a substantial cause of morbidity and reduction in quality of life. This is not only caused by a disruption in motor and sensory function from the underlying nerve injury but also by the debilitating effects of neuropathic pain resulting from symptomatic neuromas. A wide range of surgical and therapeutic modalities have been introduced to mitigate this pain. Nevertheless, no single treatment option has been successful in completely resolving the associated constellation of symptoms. While certain novel surgical techniques have shown promising results in reducing neuroma-derived and phantom limb pain, their effectiveness and the exact mechanism behind their pain-relieving capacities have not yet been defined. Furthermore
Expanded transcanal transpromontorial approach for acoustic neuroma removal. Axial sections from preoperative magnetic resonance imaging without contrast, showing a cone-shaped lesion of the internal auditory canal, extending toward the most lateral part of the cerebello-pontine angle. (A) T1-weighted high-resolution isotropic volume excitation (THRIVE) sequence; (B) T1-weighted sequence; (C
Resurgent neuropathic discharge: an obstacle to the therapeutic use of neuroma resection? Ectopic discharge ("ectopia") in damaged afferent axons is a major contributor to chronic neuropathic pain. Clinical opinion discourages surgical resection of nerves proximal to the original injury site for fear of resurgence of ectopia and exacerbated pain. We tested this concept in a well-established animal neuroma model. Teased-fiber recordings were made of ectopic spontaneous discharge originating in the experimental nerve-end neuroma and associated dorsal root ganglia in rats that underwent either a single transection (with ligation) of the sciatic nerve or 2 consecutive transections separated by 7, 14, 21, or 30 days. Ectopia emerged in afferent A and C fibers after a single cut with kinetics
Long-term comparison between blind and ultrasound-guided corticoid injections in Morton neuroma. This work compares the effectiveness of blind versus ultrasound (US)-guided injections for Morton neuroma (MN) up to 3 years of follow-up. This is an evaluator-blinded randomised trial in which 33 patients with MN were injected by an experienced orthopaedic surgeon based on anatomical landmarks . • Ultrasound-guided corticosteroid injections in Morton neuroma provide long-term pain relief in more than 75% of patients. • Ultrasound-guided injections in Morton neuroma led to greater long-term pain relief and less disability than blind injections up to 3 years of follow-up. • The presence of an ipsilateral neuroma is associated with worse long-term disability score.
Computed tomography complements ultrasound for the differential diagnosis of traumatic neuroma from recurrent tumor in patients with postoperative thyroid cancer. Traumatic neuromas (TNs) mimic recurrent tumors in US after total thyroidectomy (TT) and lateral neck dissection (LND) for thyroid cancer. We aimed to evaluate whether CT could complement US in the differential diagnosis of TNs from of TNs from recurrent tumors in postoperative thyroid cancer patients. The addition of CT to US may prevent unnecessary painful biopsy or surgery. • In the dissected neck, traumatic neuromas could mimic US suspicious LNs owing to its internal hyperechogenicity. • CT effectively differentiated traumatic neuromas from recurrent thyroid cancers by demonstrating significantly different enhancement patterns
Analysis of Related Factors Affecting Facial Nerve Function after Acoustic Neuroma Surgery. To investigate the factors affecting facial nerve function after acoustic neuroma surgery and to provide theoretical reference for clinicians to preserve facial nerve function better after surgery. A retrospective cohort study was conducted to analyze the correlation between postoperative facial nerve function and surgical approach, age, sex, tumor size and adhesion degree of facial nerve in 152 patients with acoustic neuroma. In the choice of surgical approach, there was no significant difference in the anatomy of the complete facial nerve in labyrinth path, retrosigmoid sinus path, and middle cranial fossa path. There was no statistically significant difference between the middle cranial fossa path
Assessing Surgical Approaches for Acoustic Neuroma Resection: Do Patients Perceive a Difference in Quality-of-Life Outcomes? The objective of this study is to further patient-physician discussion regarding postoperative quality of life expectations after surgical acoustic neuroma resection. This study is retrospective prospective. Qualifying patients were identified and administered Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale. The setting was Loyola University Chicago Health System. Three hundred twenty-six patients at our center with surgically resected acoustic neuroma between January 1990 and July 2021 completed the PANQOL. During postresection follow-up visits, patients were administered the PANQOL survey. The total PANQOL is comprised of questions addressing quality of life