Photo Credit: Jose Luis Calvo Martin & Jose Enrique Garcis-Maurino Muzquiz
The following is a summary of “Excision of large median and ulnar nerve schwannomas: a case series,” published in the October 2024 issue of Surgery by Chang et al.
Schwannomas are benign tumors that evolve from Schwann cells in peripheral nerves, often affecting the median and ulnar nerves in the forearm and wrist.
Researchers conducted a retrospective study evaluating treatment strategies and outcomes for patients with large median and ulnar nerve schwannomas.
They enrolled 15 patients with schwannomas larger than 2 cm in the median or ulnar nerve at the forearm and wrist, with a mean age of 61 years for the median nerve and 68 years for the ulnar nerve (2012 and 2023) and a mean follow-up of 26.9 months.
The results showed that after surgery, all 12 patients with median nerve schwannomas experienced mild, transient numbness affecting fewer than 2 digits that resolved within 6 months without motor deficits. Additionally, 2 of the 3 patients with ulnar nerve schwannomas experienced mild numbness, resolving within 6 months. Still, all developed ulnar claw hand deformity, which persisted but improved at the last follow-up. Patients were satisfied with surgery due to relief from severe tingling pain.
They concluded that careful dissection during schwannoma removal can minimize sensory deficits while addressing the risk of significant motor deficits in motor-dominant nerves like the ulnar nerve, which requires thorough preoperative discussion and potential interfascicular nerve grafting.
Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02583-0
