Brachial plexus palsy after Nuss procedure for pectus excavatum
Min-Wook Kim1, Jin Yong Jeong1, Geol Ha2
1Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Turk Gogus Kalp Damar Cerrahisi Dergisi
|February 22, 2020
Summary
Brachial plexus palsy after the Nuss procedure may stem from a narrowed costoclavicular space, not surgical positioning. This rare complication in pectus excavatum patients fully resolved in one case.
Area of Science:
- Thoracic surgery
- Neurology
- Pediatric surgery
Background:
- The Nuss procedure is a common surgical technique for correcting pectus excavatum.
- Brachial plexus palsy is a rare but potential complication following thoracic surgeries.
- Nerve injury can occur due to surgical positioning or direct trauma.
Observation:
- A 21-year-old male developed brachial plexus palsy after undergoing the Nuss procedure.
- Pre-operative costoclavicular space measured 7.60 mm, narrowing to 2.83 mm post-operatively.
- The costoclavicular space increased to 4.51 mm after the removal of the upper bar.
Findings:
- The study suggests that narrowing of the costoclavicular space, rather than surgical positioning, may be the primary cause of brachial plexus palsy post-Nuss procedure.
- The patient experienced full recovery of symptoms.
- This finding challenges the conventional understanding of the etiology of this complication.
Implications:
- Clinicians should consider monitoring costoclavicular space dimensions in patients undergoing the Nuss procedure.
- Further research is warranted to elucidate the precise mechanisms linking costoclavicular space changes to brachial plexus palsy.
- This case report may inform surgical technique modifications to minimize the risk of neurovascular complications.
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