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Periferik Sinir Yaralanmaları: Güncel Cerrahi Yönetim Stratejileri

Yıl 2024, Cilt: 63 Sayı: 3, 487 - 500, 09.09.2024

Sahar Ebrahem Orif Yiğit Uyanıkgil

https://doi.org/10.19161/etd.1501328

Öz

Amaç: Periferik sinir yaralanmaları (PSY) yaşayan birçok birey kalıcı sakatlıklarla karşı karşıya kalmakta ve bu durum önemli bir sağlık sorunu oluşturmaktadır. PSY, delici yaralanmalar, sıkışma, gerilme ve iskemik gibi çeşitli nedenlerden kaynaklanabilir ve her biri farklı klinik semptomlarla ortaya çıkar. Bu derleme, periferik sinir anatomisinin ayrıntılı bir açıklamasını sunarak temel PSY kavramlarını yeniden gözden geçirmeyi amaçlamaktadır. Ayrıca, periferik sinir hasarını takip eden patofizyolojik süreçleri araştırmakta ve PSY sınıflandırmalarına dayalı olarak vücudun kendini yenileme kapasitesini destekleyen veya engelleyen faktörleri vurgulamaktadır. İncelemede ayrıca, PSY'lerin tedavisinde mevcut olan güncel terapötik nöroşirürji yaklaşımları da tanımlanmaktadır.

Yöntem: Bu derleme, çeşitli yaralanma türlerini aydınlatmak amacıyla periferik sinirlerin anatomisini titizlikle tartışmaktadır. Periferik sinir yaralanmalarının tetiklediği spesifik patofizyolojik mekanizmalara dalmakta ve yenilenmeyi etkileyen ilgili faktörleri incelemektedir. Ayrıca, PSY'lerin ele alınmasında kullanılan güncel terapötik nöroşirürji stratejilerini de açıklamaktadır.

Sonuçlar: PSY'lerin yönetimi için nöroşirürji stratejilerine dair önceki literatürlerin gözden geçirilmesi, cerrahi prosedürlerin genellikle gerekli olmasına rağmen, çok pahalı olduğunu ve immünosupresyon, kromozomal anormallikler ve tümör oluşumu gibi çeşitli yan etkiler nedeniyle kullanımının sınırlı kaldığını göstermektedir.

Sonuç: Yaralanmanın kaynağı, yeri ve kapsamı dikkate alındığında, PSY'lerin tedavisinde cerrahi ve cerrahi olmayan yaklaşımların her ikisi de avantaj sağlamaktadır. İnsidans, mevcut uygulamalar, sonuçlar ve araştırma türlerine ilişkin kapsamlı verilerle desteklenen alandaki gelişmeler, yenilikçi tedavi tekniklerine yol açmıştır. Bununla birlikte, tam fonksiyonel iyileşme sağlamak, geniş kapsamlı araştırma çabalarına rağmen hala önemli bir zorluk olarak kalmaktadır.

Anahtar Kelimeler

Periferik sinir yaralanma cerrahi stratejiler

Kaynakça

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Peripheral Nerve Injuries: The Recent Surgical Management Strategies

Yıl 2024, Cilt: 63 Sayı: 3, 487 - 500, 09.09.2024

Sahar Ebrahem Orif Yiğit Uyanıkgil

https://doi.org/10.19161/etd.1501328

Öz

Objectives: Numerous individuals with peripheral nerve injuries (PNIs) have permanent disability, which is a major health concern. There are a number of potential causes of PNIs, including piercing injuries, compression, stretch, and ischemia. These injuries can present with a variety of clinical symptoms.
Methodology: In order to clarify the many forms of injury, the peripheral nerve's anatomy is thoroughly explained in this review, which attempts to revisit key PNI ideas. In addition, the specific pathophysiological processes that follow a peripheral nerve damage and the related variables that might either support or undermine the body's ability to regenerate itself depending on PNIs classifications are also mentioned. Next, the recent therapeutic neurosurgical approaches that are accessible in cases of PNIs are described.
Results: Following our overview of the previous literatures on neurosurgical strategies for the management of PNIs, we can observe that surgical procedures are unfortunately very expensive and that their use has been limited due to a variety of adverse effects, such as immunosuppression, chromosomal abnormalities, and tumorigenicity.
Conclusion: In accordance with the source, location and extent of the injury, there are currently advantages to treating PNIs with both surgical and non-surgical approaches. These days, it is possible to identify innovative techniques with the aid of good information regarding incidences, existing practice, outcomes, and study types. Despite a great deal of research on this topic, full functional recovery is still a problem that has to be solved.

Anahtar Kelimeler

Peripheral Nerve Injuries Surgical Strategies

Kaynakça

  • Althagafi A, Nadi M. Acute Nerve Injury. StatPearls [Internet]. 2023 Aug 7 [cited 2024 Jun 13]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK549848/
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  • Bhatnagar D, Bushman JS, Murthy NS, Merolli A, Kaplan HM, Kohn J. Fibrin glue as a stabilization strategy in peripheral nerve repair when using porous nerve guidance conduits. J Mater Sci Mater Med [Internet]. 2017 May 1 [cited 2024 Jun 11];28(5). Available from: https://pubmed.ncbi.nlm.nih.gov/28389905/
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  • Sunderland S. The pros and cons of funicular nerve repair. J Hand Surg Am. 1979 May 1;4(3):201–11.
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  • Barros LC, Ferreira RS, Barraviera SRCS, Stolf HO, Thomazini-Santos IA, Mendes-Giannini MJS, et al. A new fibrin sealant from Crotalus durissus terrificus venom: applications in medicine. J Toxicol Environ Health B Crit Rev [Internet]. 2009 [cited 2024 Jun 13];12(8):553–71. Available from: https://pubmed.ncbi.nlm.nih.gov/20183534/
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Toplam 83 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Periferik Sinir Sistemi
Bölüm Derlemeler
Yazarlar

Sahar Ebrahem Orif 0000-0002-4159-0196

Yiğit Uyanıkgil 0000-0002-4016-0522

Yayımlanma Tarihi 9 Eylül 2024
Gönderilme Tarihi 14 Haziran 2024
Kabul Tarihi 12 Temmuz 2024
Yayımlandığı Sayı Yıl 2024Cilt: 63 Sayı: 3

Kaynak Göster

Vancouver Ebrahem Orif S, Uyanıkgil Y. Peripheral Nerve Injuries: The Recent Surgical Management Strategies. ETD. 2024;63(3):487-500.
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