METHODS: Between August 2020 and July 2022, we operated on 117 sides with TTS. This retrospective study examined data from 8 consecutive patients (8 sides: 5 men, 3 women; average age 67.8 years) with an extraneural ganglion in the tarsal tunnel. We investigated the clinical characteristics and surgical outcomes for these patients.
RESULTS: The mass was palpable through the skin in 1 patient, detected intraoperatively in 1 patient, and visualized on MRI scanning in the other 6 patients. Symptoms involved the medial plantar nerve area (n = 5), lateral plantar nerve area (n = 1), and medial and lateral plantar nerve areas (n = 2). The interval between symptom onset and surgery ranged from 4 to 168 months. Adhesion between large (≥20 mm) ganglia and surrounding tissue and nerves was observed intraoperatively in 4 patients. Of the 8 patients, 7 underwent total ganglion resection. There were no surgery-related complications. On their last postoperative visit, 3 patients with a duration of symptoms not exceeding 10 months reported favorable outcomes.
CONCLUSIONS: Because ganglia eliciting TTS are often undetectable by skin palpation, imaging studies may be necessary. Early surgical intervention appears to yield favorable outcomes.
方法:在2020年8月至2022年7月之间,我们使用TTS在117个侧面进行了操作。这项回顾性研究检查了8名连续患者的数据(8侧:5名男性,3名妇女;平均年龄67.8岁),tar骨隧道中有神经外神经节。我们调查了这些患者的临床特征和手术结果。
结果:1例患者皮肤可见肿块,术中检测到1例患者,并在其他6例患者的MRI扫描中可视化。症状涉及足底内侧神经区(n=5),足底外侧神经区(n=1),足底内侧和外侧神经区(n=2)。症状发作和手术之间的间隔为4至168个月。4例患者术中观察到大(≥20mm)神经节与周围组织和神经之间的粘附。在这8名患者中,7例行全神经节切除术。无手术相关并发症。在他们最后一次术后就诊时,3例症状持续时间不超过10个月的患者报告了良好的结果。
结论:由于皮肤触诊通常无法检测到引起TTS的神经节,影像学检查可能是必要的。早期手术干预似乎产生有利的结果。