neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2019-21-4-89-96neurosurgery-794Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEИнтраневральный ганглион малоберцового нерва: 3 клинических случая и обзор литературыIntraneural ganglion of the peroneal nerve: a report of 3 cases and literature reviewhttps://orcid.org/0000-0002-6715-6021ЕвзиковГ. Ю.EvzikovG. Yu.

разработка дизайна исследования, проведение оперативного вмешательства, научное редактирование текста статьи

developing the research design, surgical treatment, scientific editing of the article

https://orcid.org/0000-0002-0442-4770БашлачевМ. Г.BashlachevM. G.

Михаил Григорьевич Башлачев 

обзор публикаций по теме статьи, написание текста статьи

reviewing of publications on the article’s theme, article writing

bashlachev.m@gmail.comhttps://orcid.org/0000-0003-3585-5976ФарафонтовА. В.FarafontovA. V.

обзор публикаций по теме статьи, анализ полученных данных

reviewing of publications on the article’s theme, analysis of the obtained data

НикитинС. С.NikitinS. S.

разработка дизайна исследования

developing the research design

https://orcid.org/0000-0003-2622-7804ГребеневФ. В.GrebenevF. V.

обзор публикаций по теме статьи, написание текста статьи

reviewing of publications on the article’s theme, article writing

ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian Federation2019211220192148996Copyright © Евзиков Г.Ю., Башлачев М.Г., Фарафонтов А.В., Никитин С.С., Гребенев Ф.В., 20192019Евзиков Г.Ю., Башлачев М.Г., Фарафонтов А.В., Никитин С.С., Гребенев Ф.В.Evzikov G.Y., Bashlachev M.G., Farafontov A.V., Nikitin S.S., Grebenev F.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/794

Цель работы – описать 3 клинических случая интраневральной кисты (ганглиона) малоберцового нерва и сопоставить собственные наблюдения с данными научной литературы.

Клинические наблюдения

Клинические наблюдения. В нейрохирургическом отделении клиники нервных болезней им. А.Я. Кожевникова Первого Московского государственного медицинского университета им. И.М. Сеченова с 2013 по 2019 г. находились на лечении 3 пациента с интраневральным ганглионом общего малоберцового нерва. У всех пациентов проведено широкое рассечение стенки кисты, эвакуация секрета (в 2 случаях с перевязкой суставной ветви нерва, в 1 случае суставная ветвь не выявлена). Полное восстановление нерва зарегистрировано во всех наблюдениях.

Заключение

Заключение. По нашему мнению, вскрытие ганглиона с использованием операционного микроскопа и микрохирургической техники не является сложной и опасной для нерва манипуляцией, поэтому отказ от вскрытия ганглиона представляется нам неоправданным.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Информированное согласие

Информированное согласие. Все пациенты подписали информированное согласие на публикацию своих данных.

The objective is to report 3 cases of intraneural cyst (ganglion) of the peroneal nerve and compare our own findings with the data from scientific literature.

Case reports

Case reports. Three patients with intraneural ganglions of the common peroneal nerve were treated in the Department of Neurosurgery, A.Ya. Kozhevnikov Clinic of Nervous Diseases, I.M. Sechenov First Moscow State Medical University between 2013 and 2019. All patients underwent extensive dissection of the cyst wall, evacuation of secretion; 2 of them had ligation of the articular nerve branch, while in one patient, the articular branch was not revealed. Complete nerve recovery was registered in all cases.

Conclusion

Conclusion. We believe that ganglion dissection using microsurgical techniques with surgical microscope is a safe and noncomplex procedure; therefore, the avoidance of this manipulation seems unjustified.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Informed consent

Informed consent. All patients gave written informed consent to the publication of their data.

интраневральный ганглионобщий малоберцовый нервхирургическое лечениеintraneural ganglioncommon peroneal nervesurgical treatmentИсследование проведено без спонсорской поддержки.The study was performed without external funding.ReferencesKim D., Choi J.G., Son B.C. Peroneal nerve palsy due to subparaneurial ganglion cyst, a rare variant of intraneural ganglion cyst. Asian J Neurosurg 2018;13(4):1225–8. DOI: 10.4103/ajns.AJNS_6_17.Kim D., Choi J.G., Son B.C. Peroneal nerve palsy due to subparaneurial ganglion cyst, a rare variant of intraneural ganglion cyst. Asian J Neurosurg 2018;13(4):1225–8. DOI: 10.4103/ajns.AJNS_6_17.Panwar J., Mathew A., Thomas B.P. Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst? World J Radiol 2017;9(5):230–44. DOI: 10.4329/wjr.v9.i5.230.Panwar J., Mathew A., Thomas B.P. Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst? World J Radiol 2017;9(5):230–44. DOI: 10.4329/wjr.v9.i5.230.Hartwell A.S. Cystic tumor of median nerve, operation: restoration of function. Boston Med Surg J 1901;144:582–3.Hartwell A.S. Cystic tumor of median nerve, operation: restoration of function. Boston Med Surg J 1901;144:582–3.Sultan C. Ganglion der Nervenscheide des Nervus Peroneus. Zentralblatt fur Chirurgie 1921;48:963–5.Sultan C. Ganglion der Nervenscheide des Nervus Peroneus. Zentralblatt fur Chirurgie 1921;48:963–5.Евзиков Г.Ю., Фарафонтов А.В., Панина Т.Н. Интраневральный ганглион – редкая причина невропатии малоберцового нерва. Неврологический журнал 2014;19(4):28–32.Evzikov G.Yu., Faraphontov A.V., Panina T.N. Intraneural ganglion is a rare cause of peroneal nerve neuropathy. Nevrologichesky zhurnal = Neurological Journal 2014;19(4):28–32. (In Russ.).Squires J.H., Emery K.H., Johnson N., Sorger J. Tibial nerve intraneural ganglion cyst in a 10-year-old boy. Pediatr Radiol 2014;4(4):488–90. DOI: 10.1007/s00247-013-2814-y.Squires J.H., Emery K.H., Johnson N., Sorger J. Tibial nerve intraneural ganglion cyst in a 10-year-old boy. Pediatr Radiol 2014;4(4):488–90. DOI: 10.1007/s00247-013-2814-y.Allieu P.Y., Cenac P.E. Peripheral nerve mucoid degeneration of the upper extremity. J Hand Surg Am 1989;14(2 Pt 1): 189–94. DOI: 10.1016/0363-5023(89)90004-x.Allieu P.Y., Cenac P.E. Peripheral nerve mucoid degeneration of the upper extremity. J Hand Surg Am 1989;14(2 Pt 1): 189–94. DOI: 10.1016/0363-5023(89)90004-x.Jaradeh S., Sanger J.R., Maas E.F. Isolated sensory impairment of the thumb due to an intraneural ganglion cyst in the median nerve. J Hand Surg Br 1995;20(4):475–8. DOI: 10.1016/s0266-7681(05)80156-1.Jaradeh S., Sanger J.R., Maas E.F. Isolated sensory impairment of the thumb due to an intraneural ganglion cyst in the median nerve. J Hand Surg Br 1995;20(4):475–8. DOI: 10.1016/s0266-7681(05)80156-1.Naam N.H., Carr S.B., Massoud A.H. Intraneural ganglions of the hand and wrist. J Hand Surg Am 2015;40(8):1625–30. DOI: 10.1016/j.jhsa.2015.05.025.Naam N.H., Carr S.B., Massoud A.H. Intraneural ganglions of the hand and wrist. J Hand Surg Am 2015;40(8):1625–30. DOI: 10.1016/j.jhsa.2015.05.025.Ratanshi I., Clark T.A., Giuffre J.L. Immediate nerve transfer for the treatment of peroneal nerve palsy secondary to an intraneural ganglion: case report and review. Plast Surg 2017;25(1):54–8. DOI: 10.1177/2292550317694842.Ratanshi I., Clark T.A., Giuffre J.L. Immediate nerve transfer for the treatment of peroneal nerve palsy secondary to an intraneural ganglion: case report and review. Plast Surg 2017;25(1):54–8. DOI: 10.1177/2292550317694842.Lu H., Chen L.F., Jiang S., Shen H. A rapidly progressive foot drop caused by the posttraumatic intraneural ganglion cyst of the deep peroneal nerve. BMC Musculoskelet Disord 2018;19(1):298. DOI: 10.1186/s12891-018-2229-x.Lu H., Chen L.F., Jiang S., Shen H. A rapidly progressive foot drop caused by the posttraumatic intraneural ganglion cyst of the deep peroneal nerve. BMC Musculoskelet Disord 2018;19(1):298. DOI: 10.1186/s12891-018-2229-x.Spinner R.J., Crnkovich F., Ahmed Ibrahim Kobeal M., Amrami K.K. Can trauma cause tibial intraneural ganglion cysts at the superior tibiofibular joint? Clin Anat 2012;25(6):785–7. DOI: 10.1002/ca.2207913.Spinner R.J., Crnkovich F., Ahmed Ibrahim Kobeal M., Amrami K.K. Can trauma cause tibial intraneural ganglion cysts at the superior tibiofibular joint? Clin Anat 2012;25(6):785–7. DOI: 10.1002/ca.2207913.De Schrijver F., Simon J.P., De Smet L., Fabry G. Ganglia of the superior tibiofibular joint: report of three cases and review of the literature. Acta Orthop Belg 1998;64(2):233–41.De Schrijver F., Simon J.P., De Smet L., Fabry G. Ganglia of the superior tibiofibular joint: report of three cases and review of the literature. Acta Orthop Belg 1998;64(2):233–41.Wadstein T. Two cases of ganglia in the sheath of the peroneal nerve. Acta Orthop 1932;2(1–4):221–31.Wadstein T. Two cases of ganglia in the sheath of the peroneal nerve. Acta Orthop 1932;2(1–4):221–31.Spinner R.J., Atkinson J.L., Scheithauer B.W. et al. Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. J Neurosurg 2003;99(2):319–29. DOI: 10.3171/jns.2003.99.2.0319.Spinner R.J., Atkinson J.L., Scheithauer B.W. et al. Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. J Neurosurg 2003;99(2):319–29. DOI: 10.3171/jns.2003.99.2.0319.Spinner R.J., Desy N.M., Amrami K.K. Sequential tibial and peroneal intraneural ganglia arising from the superior tibiofibular joint. Skeletal Radiol 2008;37(1):79–84. DOI: 10.1007/s00256-007-0400-9.Spinner R.J., Desy N.M., Amrami K.K. Sequential tibial and peroneal intraneural ganglia arising from the superior tibiofibular joint. Skeletal Radiol 2008;37(1):79–84. DOI: 10.1007/s00256-007-0400-9.Isaacs A.M., Midha R., Desy N.M. et al. The mechanism underlying combined medial and lateral plantar and tibial intraneural ganglia in the tarsal tunnel. Acta Neurochir (Wien) 2016;158(11):2225–9. DOI: 10.1007/s00701-016-2930-1.Isaacs A.M., Midha R., Desy N.M. et al. The mechanism underlying combined medial and lateral plantar and tibial intraneural ganglia in the tarsal tunnel. Acta Neurochir (Wien) 2016;158(11):2225–9. DOI: 10.1007/s00701-016-2930-1.Muramatsu K., Hashimoto T., Tominaga Y. et al. Unusual peroneal nerve palsy caused by intraneural ganglion cyst: pathological mechanism and appropriate treatment. Acta Neurochir (Wien) 2013;155(9):1757–61. DOI: 10.1007/s00701-013-1768-z.Muramatsu K., Hashimoto T., Tominaga Y. et al. Unusual peroneal nerve palsy caused by intraneural ganglion cyst: pathological mechanism and appropriate treatment. Acta Neurochir (Wien) 2013;155(9):1757–61. DOI: 10.1007/s00701-013-1768-z.Sobol G.L., Lipschultz T.M. Successful surgical treatment of an intraneural ganglion of the common peroneal nerve. Am J Orthop (Belle Mead NJ) 2015;44(4):E123–6.Sobol G.L., Lipschultz T.M. Successful surgical treatment of an intraneural ganglion of the common peroneal nerve. Am J Orthop (Belle Mead NJ) 2015;44(4):E123–6.Patel P., Schucany W.G. A rare case of intraneural ganglion cyst involving the tibial nerve. Proc (Bayl Univ Med Cent) 2012;25(2):132–5. DOI: 10.1080/08998280.2012.11928809.Patel P., Schucany W.G. A rare case of intraneural ganglion cyst involving the tibial nerve. Proc (Bayl Univ Med Cent) 2012;25(2):132–5. DOI: 10.1080/08998280.2012.11928809.Wilson T.J., Mauermann M.L., Rock M.G., Spinner R.J. Outcomes following surgery for peroneal intraneural ganglion cysts. Muscle Nerve 2018;57(6):989–93. DOI: 10.1002/mus.26062.Wilson T.J., Mauermann M.L., Rock M.G., Spinner R.J. Outcomes following surgery for peroneal intraneural ganglion cysts. Muscle Nerve 2018;57(6):989–93. DOI: 10.1002/mus.26062.Young N.P., Sorenson E.J., Spinner R.J., Daube J.R. Clinical and electrodiagnostic correlates of peroneal intraneural ganglia. Neurology 2009;72(5):447–52. DOI: 10.1212/01.wnl.0000341787.70467.99.Young N.P., Sorenson E.J., Spinner R.J., Daube J.R. Clinical and electrodiagnostic correlates of peroneal intraneural ganglia. Neurology 2009;72(5):447–52. DOI: 10.1212/01.wnl.0000341787.70467.99.Салтыкова В.Г., Меркулов М.В. Ультразвуковая диагностика редких форм псевдоопухолевых образований периферических нервов. Ультразвуковая и функциональная диагностика 2011;(3):52–8.Saltykova V.G., Merkulov M.V. Ultrasound diagnostics of peripheral nerves tumour like lesions. Ultrazvukovaya i funktsionalnaya diagnostika = Ultrasound and Functional Diagnostics 2011;(3):52–8. (In Russ.).Iverson D.J. MRI detection of cysts of the knee causing common peroneal neuropathy. Neurology 2005;65(11):1829–31. DOI: 10.1212/01.wnl.0000187098.42938.b6.Iverson D.J. MRI detection of cysts of the knee causing common peroneal neuropathy. Neurology 2005;65(11):1829–31. DOI: 10.1212/01.wnl.0000187098.42938.b6.Bonar S.F., Viglione W., Schatz J. et al. An unusual variant of intraneural ganglion of the common peroneal nerve. Skeletal Radiol 2006;35(3):165–71. DOI: 10.1007/s00256-005-0031-y.Bonar S.F., Viglione W., Schatz J. et al. An unusual variant of intraneural ganglion of the common peroneal nerve. Skeletal Radiol 2006;35(3):165–71. DOI: 10.1007/s00256-005-0031-y.Van den Bergh F.R., Vanhoenacker F.M., De Smet E. et al. Peroneal nerve: normal anatomy and pathologic findings on routine MRI of the knee. Insights Imaging 2013;4(3):287–99. DOI: 10.1007/s13244-013-0255-7.Van den Bergh F.R., Vanhoenacker F.M., De Smet E. et al. Peroneal nerve: normal anatomy and pathologic findings on routine MRI of the knee. Insights Imaging 2013;4(3):287–99. DOI: 10.1007/s13244-013-0255-7.Desy N.M., Wang H., Elshiekh M.A. et al. Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg 2016;125(3):615–30. DOI: 10.3171/2015.9.JNS141368.Desy N.M., Wang H., Elshiekh M.A. et al. Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg 2016;125(3):615–30. DOI: 10.3171/2015.9.JNS141368.Prasad N.K., Desy N.M., Howe B.M. et al. Subparaneurial ganglion cysts of the fbular and tibial nerves: a new variant of intraneural ganglion cysts. Clin Anat 2016;29(4):530–7. DOI: 10.1002/ca.22671.Prasad N.K., Desy N.M., Howe B.M. et al. Subparaneurial ganglion cysts of the fbular and tibial nerves: a new variant of intraneural ganglion cysts. Clin Anat 2016;29(4):530–7. DOI: 10.1002/ca.22671.Spinner R.J., Hébert-Blouin M.N., Amrami K.K., Rock M.G. Peroneal and tibial intraneural ganglion cysts in the knee region: a technical note. Neurosurgery 2010;67(3 Suppl Operative):ons71–8. DOI: 10.1227/01.NEU.0000374683. 91933.0E.Spinner R.J., Hébert-Blouin M.N., Amrami K.K., Rock M.G. Peroneal and tibial intraneural ganglion cysts in the knee region: a technical note. Neurosurgery 2010;67(3 Suppl Operative):ons71–8. DOI: 10.1227/01.NEU.0000374683. 91933.0E.Stamatis E.D., Manidakis N.E., Patouras P.P. Intraneural ganglion of the superficial peroneal nerve: a case report. J Foot Ankle Surg 2010;49(4):400.e1–4. DOI: 10.1053/j.jfas.2010.04.012.Stamatis E.D., Manidakis N.E., Patouras P.P. Intraneural ganglion of the superficial peroneal nerve: a case report. J Foot Ankle Surg 2010;49(4):400.e1–4. DOI: 10.1053/j.jfas.2010.04.012.Miskovsky S., Kaeding C., Weis L. Proximal tibiofibular joint ganglion cysts: excision, recurrence, and joint arthrodesis. Am J Sports Med 2004;32(4):1022–8.Miskovsky S., Kaeding C., Weis L. Proximal tibiofibular joint ganglion cysts: excision, recurrence, and joint arthrodesis. Am J Sports Med 2004;32(4):1022–8.Liang T., Panu A., Crowther S. et al. Ultrasound-guided aspiration and injection of an intraneural ganglion cyst of the common peroneal nerve. HSS J 2013;9(3):270–4. DOI: 10.1007/s11420-013-9345-9.Liang T., Panu A., Crowther S. et al. Ultrasound-guided aspiration and injection of an intraneural ganglion cyst of the common peroneal nerve. HSS J 2013;9(3):270–4. DOI: 10.1007/s11420-013-9345-9.

The authors declare that there are no conflicts of interest present.