Sonographic features of traumatic neuromas after neck dissection

Abstract

Distinctive sonographic features, sharp pain during FNAB, and low Tg levels in FNAB washout fluid can help to diagnose traumatic neuromas without surgery.

Preliminary study of the types of traumatic peripheral nerve injuries by ultrasound

“…Lee and associates [14] performed a retrospective analysis of 13 patients undergoing ultrasonographic evaluation and surgical treatment of nerve lesions and the results suggested US was an effective imaging investigation that augmented electrophysiological and other neuroimaging studies. The other reports [5,15,16] about traumatic peripheral nerve injuries concern themselves mainly with the traumatic neuroma diagnosed by US.…”

Identification of Continuity of Transected Nerve on Sonography After Neck Dissection: Direct Sign of Traumatic Neuroma

“…Although US can help diagnose traumatic neuroma, there are overlaps between traumatic neuroma and metastatic lymph node, thus making these findings suggestive rather than diagnostic. In addition, none of these reports showed direct continuity of the transected nerve, perhaps due to the size discrepancy of the transected nerves between the knee and head and neck region (1,2). Nevertheless, understanding of related anatomy may be crucial in detecting continuity of the transected nerve.…”

“…In the head and neck regions, especially after neck dissection for malignancy, traumatic neuroma may be easily confused with a metastatic lymph node, thereby increasing patient anxiety and necessitating fine needle aspiration (FNA) (1)(2)(3). To date, several reports have documented the indirect ultrasonographic (US) features of traumatic neuroma after neck dissection; among the characteristics distinguishing traumatic neuroma from metastatic lymph node are the frequent occurrence of a central hyperechoic area, a smaller short axis diameter, and a smaller short-to-long axis ratio (1,2). However, there have been no reports showing the direct continuity of a transected nerve after neck dissection in patients with traumatic neuroma.…”

Characteristic Ultrasound Feature of Traumatic Neuromas After Neck Dissection: Direct Continuity with the Cervical Plexus

“…Traumatic neuroma has been reported to occur in 1.1%-2.7% of patients who undergo neck dissection (8)(9)(10). Although painful hypersensitivity or paresthesia is a characteristic symptom of traumatic neuroma, some patients are asymptomatic.…”

“…Although painful hypersensitivity or paresthesia is a characteristic symptom of traumatic neuroma, some patients are asymptomatic. Traumatic neuromas may therefore be easily confused with recurrent lymphadenopathy, causing patient anxiety and the need for fine-needle aspiration (FNA) (8)(9)(10). Since FNA results may be nondiagnostic, some patients require surgical excision for a confirmative diagnosis (11,12).…”