Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor

Luciano Foroni; Mário Gilberto Siqueira; Roberto Sérgio Martins; Carlos Otto Heise; Hugo Sterman Neto; Adriana Yoriko Imamura

doi:10.1590/0004-282X20170148

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(11): 796-800
DOI: 10.1590/0004-282X20170148

Article

Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor

Boa recuperação da sensibilidade da mão usando o nervo intercostobraquial como doador em cirurgia do plexo braquial

Luciano Foroni

¹Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia de Nervos Periféricos. São Paulo SP, Brasil

,

Mário Gilberto Siqueira

¹Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia de Nervos Periféricos. São Paulo SP, Brasil

,

Roberto Sérgio Martins

¹Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia de Nervos Periféricos. São Paulo SP, Brasil

,

Carlos Otto Heise

²Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil

³Instituto Fleury, Departamento de Neurofisiologia, São Paulo SP Brasil

,

Hugo Sterman Neto

⁴Universidade de São Paulo, Departamento de Neurologia, Divisão de Neurocirurgia, São Paulo SP, Brasil

,

Adriana Yoriko Imamura

⁵Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Terapia de Mão, São Paulo SP, Brasil

› Author Affiliations

Abstract

ABSTRACT

Objective: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor.

Methods: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed.

Results: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient.

Conclusion: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.

RESUMO

Objetivo: A restauração da sensibilidade em pacientes com lesão completa do plexo braquial é muito importante. O objetivo desse estudo foi avaliar a recuperação sensitiva em cirurgia do plexo braquial utilizando o nervo intercostobraquial (NICB) como doador.

Métodos: Onze pacientes foram submetidos a reconstrução sensitiva usando o NICB como doador para a contribuição lateral do nervo mediano, com tempo de acompanhamento pós-operatório médio de 41 meses. Um protocolo de avaliação foi realizado.

Resultados: Quatro pacientes perceberam o filamento 1-verde. Os filamentos 2-azul, 3-roxo e 4-vermelho foram percebidos por um, dois e três pacientes, respectivamente. Um paciente não apresentou recuperação sensitiva. Dois pacientes obtiveram recuperação S3, dois S2+, seis S2 e um S0, pela escala de Highet.

Conclusão: O procedimento usando o NICB como doador promove boa intensidade de recuperação sensitiva e bons resultados são obtidos quanto ao local de percepção em pacientes com avulsão completa do plexo braquial.

Keywords:

brachial plexus - intercostal nerves - median nerve - nerve transfer - sensation - perception

Palavras-chave:

plexo braquial - nervos intercostais - nervo mediano - transferência de nervo - sensação - percepção

Full Text

References

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