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Amputation neuromas after neck dissection.

Yoav P Talmi1, Lev Bedrin, Shay Dori

  • 1Department of Otolaryngology-Head and Neck Surgery, the Chaim Sheba Medical Center, Tel Hashomer, Israel. talmi@attglobal.net

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 26, 2003
PubMed
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Neuroma formation is rare after neck dissection. In a study of 185 procedures, no palpable neuromas were found, highlighting the need to distinguish these rare lesions from cancer recurrence.

Area of Science:

  • Head and Neck Surgery
  • Surgical Pathology

Background:

  • Neuromas can arise from transected nerves, potentially mimicking recurrent cancer after neck dissection.
  • The incidence and clinical significance of neuroma formation following neck dissection require further elucidation.

Purpose of the Study:

  • To determine the incidence of neuroma formation after neck dissection in a large patient cohort.
  • To assess the clinical presentation and diagnostic challenges of neuromas in this context.

Main Methods:

  • A retrospective review of 185 neck dissections performed over a 2-year period in 153 patients.
  • Patient follow-up ranged from 3 months to 10 years (mean 52 months).
  • Nerve edges were not routinely ligated or cauterized; operative records were analyzed for nerve stump management.

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Main Results:

  • No palpable neuromas were detected in any of the neck dissection cases.
  • A single case of a histologically confirmed neuroma was identified in a revised neck, which was macroscopically indiscernible.
  • In most cases, nerve stumps (great auricular nerve, cervical branches) were left intact post-resection.

Conclusions:

  • Neuroma formation is exceptionally rare following neck dissection, with no palpable cases observed in this series.
  • It is crucial to differentiate potential neuromas from recurrent malignancy, as they share similar clinical presentations.
  • Current findings do not support routine intervention on cut nerve edges to prevent neuroma formation.