The cubital tunnel syndrome caused by the intraneural or extraneural ganglion cysts: Case report and review of the literature

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 70; no. 10; pp. 1404 - 1408
• Main Authors: Chang, Wen Kai, Li, Yong Ping, Zhang, Deng Feng, Liang, Bing Sheng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2017
• Subjects: China; Cubital tunnel syndrome; Cubital Tunnel Syndrome - diagnosis; Cubital Tunnel Syndrome - etiology; Cubital Tunnel Syndrome - physiopathology; Cubital Tunnel Syndrome - surgery; Cysts; Decompression, Surgical - methods; Elbow - innervation; Elbow - pathology; Elbow - surgery; Electromyography - methods; Extraneural ganglion; Female; Follow-Up Studies; Ganglion Cysts - complications; Ganglion Cysts - diagnostic imaging; Ganglion Cysts - pathology; Ganglion Cysts - surgery; Humans; Intraneural ganglion; Male; Middle Aged; Treatment Outcome; Ulnar nerve; Ulnar Nerve - pathology; Ulnar Nerve Compression Syndromes - diagnosis; Ulnar Nerve Compression Syndromes - etiology; Ulnar Nerve Compression Syndromes - physiopathology; Ulnar Nerve Compression Syndromes - surgery; Ultrasonography - methods; Extraneural ganglion; Ulnar nerve; Intraneural ganglion; Cubital tunnel syndrome; Cysts
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2017.05.006

Cubital tunnel syndrome is the second most common nerve compression syndrome in peripheral nerve compression disease. Although potential ulnar nerve entrapment can occur at multiple points along its course, such as the arcade of struthers, the medial intermuscular septum, the medial epicondyle, the cubital tunnel, and the deep flexor pronator aponeurosis, the most common site of entrapment is the cubital tunnel. However, cubital tunnel syndrome could also be caused by the occupying masses along the course of ulnar nerve, such as intraneural or extraneural ganglia. The cubital tunnel syndrome caused by intraneural or extraneural ganglion cysts has been rarely reported. In our hospital, there were 184 patients with cubital tunnel syndrome who underwent surgical treatment from January 2010 to January 2014. Of these patients, 16 had extraneural cysts and 3 had intraneural ganglion cysts. The incidence rate of cysts in the cubital tunnel was 10.33%. Electromyography was used as routine examination. Ultrasound was used only in some patients in whom elbow mass was suspected. In the surgery of the cubital tunnel syndrome combined with cyst, if any other cysts were found, we should be remove completely the cyts and decompress the ulnar nerve thoroughly with the ulnar nerve being anterior transposition. These cysts were confirmed by histopathological examination. Finally, we compared the clinical features of patients who had a medial elbow ganglion with those of patients who had only cubital tunnel syndrome. B ultrasound can significantly improve the diagnosis. All patients were followed up for 4 months to 2 years, and the curative effect was good.