Use of Vascularized, Denervated Muscle Targets for Prevention and Treatment of Upper-Extremity Neuromas

Suresh, Visakha; Schaefer, Eliana J.; Calotta, Nicholas A.; Giladi, Aviram M.; Tuffaha, Sami H.

doi:10.1016/j.jhsg.2022.06.001

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…6 Regenerative peripheral nerve interfaces are free muscle grafts lacking blood supply and are, therefore, susceptible to central necrosis and ischemia-induced fibrosis during healing. 4,7 They must be limited in size to maintain some degree of tissue viability. 7,8 As VDMTs are perfused by a vascular pedicle, they experience less ischemia-induced fibrosis and have fewer size limitations.…”

Section: Discussionmentioning

confidence: 99%

“…However, literature on their use in occipital surgery is limited to a single case report describing short-term results of using TMR and RPNIs to treat occipital nerve stumps 6 . Regenerative peripheral nerve interfaces are free muscle grafts lacking blood supply and are, therefore, susceptible to central necrosis and ischemia-induced fibrosis during healing 4,7 . They must be limited in size to maintain some degree of tissue viability 7,8 .…”

Section: Discussionmentioning

confidence: 99%

“…3 Vascularized denervated muscle targets have shown promise in treating upper extremity neuromas but have not been described in the context of headache surgery. 4 Here we describe the etiology, surgical management, and longterm outcomes of 2 patients with recurrent occipital neuralgia after occipital nerve release surgery who were subsequently successfully treated using VDMTs.…”

mentioning

confidence: 99%

“…Vascularized denervated muscle targets (VDMTs) are a novel method for treating and preventing symptomatic neuromas that function by redirecting injured axons from a regenerating nerve into denervated muscle similar to regenerative peripheral nerve interfaces (RPNIs) but vascularized, helping ensure their survival 3 . Vascularized denervated muscle targets have shown promise in treating upper extremity neuromas but have not been described in the context of headache surgery 4 . Here we describe the etiology, surgical management, and long-term outcomes of 2 patients with recurrent occipital neuralgia after occipital nerve release surgery who were subsequently successfully treated using VDMTs.…”

mentioning

confidence: 99%

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Vascularized Denervated Muscle Targets for Headache Surgery—Presentation and Surgical Management

Bhoopalam,

Colakoglu,

Tuffaha

et al. 2023

Journal of Craniofacial Surgery

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Patients with substantial trauma to their occipital nerves and those with recurrent or persistent chronic headaches after occipital nerve decompression surgery require transection of their greater occipital and/or lesser occipital nerves to control debilitating pain. Current techniques, such as burying the transected nerve stump in nearby muscle, do not prevent neuroma formation, and more advanced techniques, such as targeted muscle reinnervation and regenerative peripheral nerve interface, have demonstrated only short-term anecdotal success in the context of headache surgery. Vascularized denervated muscle targets (VDMTs) are a novel technique to address the proximal nerve stump after nerve transection that has shown promise to improve chronic nerve pain and prevent neuroma formation. However, VDMTs have not been described in the context of headache surgery. Here authors describe the etiology, workup, and surgical management of 2 patients with recurrent occipital neuralgia who developed vexing neuromas after previous surgery and were successfully treated with VDMTs, remaining pain-free at 3-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Vascularized Denervated Muscle Targets for Headache Surgery—Presentation and Surgical Management

Bhoopalam,

Colakoglu,

Tuffaha

et al. 2023

Journal of Craniofacial Surgery

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“…Direct neurotization Short-term outcomes for patients who underwent secondary VDMT for symptomatic neuromas following upper extremity amputations showed complete improvement in neuromatous pain (level VI evidence) 56 • Similar to RPNI with the added benefit of maintaining vascular perfusion to target muscle; not size limited; less versatile with limited application in some anatomical locations (ie, hands, face)…”

Section: Regenerative Peripheral Nerve Interfacementioning

confidence: 99%

Current Concepts in Lower Extremity Amputation: A Primer for Plastic Surgeons

Hanwright,

Suresh,

Shores

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After studying this article, the participant should be able to: 1. Understand the goals of lower extremity reconstruction and identify clinical scenarios favoring amputation. 2. Understand lower extremity amputation physiology and biomechanics. 3. Review soft-tissue considerations to achieve durable coverage. 4. Appreciate the evolving management of transected nerves. 5. Highlight emerging applications of osseointegration and strategies to improve myoelectric prosthetic control. Summary: Plastic surgeons are well versed in lower extremity reconstruction for traumatic, oncologic, and ischemic causes. Limb amputation is an increasingly sophisticated component of the reconstructive algorithm and is indicated when the residual limb is predicted to be more functional than a salvaged limb. Although plastic surgeons have traditionally focused on limb salvage, they play an increasingly vital role in optimizing outcomes from amputation. This warrants a review of core concepts and an update on emerging reconstructive techniques in amputee care.

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Free versus vascularized regenerative peripheral nerve interfaces in upper limb neuromas: a systematic review

Satkunabalan,

Tay,

2024

Eur J Plast Surg

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Use of Vascularized, Denervated Muscle Targets for Prevention and Treatment of Upper-Extremity Neuromas

Cited by 10 publications

References 22 publications

Vascularized Denervated Muscle Targets for Headache Surgery—Presentation and Surgical Management

Vascularized Denervated Muscle Targets for Headache Surgery—Presentation and Surgical Management

Current Concepts in Lower Extremity Amputation: A Primer for Plastic Surgeons

Free versus vascularized regenerative peripheral nerve interfaces in upper limb neuromas: a systematic review

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