Directed cutaneous neurectomy for cutaneous neuralgia.

BACKGROUND

Cutaneous neuralgia (CN) is a common challenge for surgical consultation. This report describes directed cutaneous neurectomy (DCN) for persistent CN.

METHODS

From 2010 through 2022, DCN was performed 112 times in 100 patients. All had complete temporary relief of CN by outpatient percutaneous proximal blockade. DCN involved a successful proximal blockade with blue dye added to the injectate, and all blue stained tissue was excised. The site of DCN included groin (49 patients), abdomen (38 patients), chest (7 patients), extremity (4 patients), or skull (2 patients). Relief was judged continuous (C), none (N), or temporary (T).

RESULTS

Pain relief was C in 82 patients (27 ​± ​20 ​mo), N in 6 patients, and T in 12 patients (22 ​± ​2 ​mo). The presence of microscopic nerve fibers (46 patients) or mesh (42 patients) did not affect outcome. A second DCN was done in two N patients, followed by C relief. A second DCN was done in seven T patients, and a third DCN was done in three T patients after recurrent CN.

CONCLUSIONS

Refractory CN can usually be successfully treated by DCN.