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Ganglia-Induced Tarsal Tunnel Syndrome
1Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
2Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan
3Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Background: Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy that is sometimes elicited by ganglia in the tarsal tunnel.
Methods: Between August 2020 and July 2022, we operated on 117 sides with TTS. This retrospective study examined data from 8 consecutive patients (8 sides: 5 men, 3 women; average age 67.8 years) with an extraneural ganglion in the tarsal tunnel. We investigated the clinical characteristics and surgical outcomes for these patients.
Results: The mass was palpable through the skin in 1 patient, detected intraoperatively in 1 patient, and visualized on MRI scanning in the other 6 patients. Symptoms involved the medial plantar nerve area (n = 5), lateral plantar nerve area (n = 1), and medial and lateral plantar nerve areas (n = 2). The interval between symptom onset and surgery ranged from 4 to 168 months. Adhesion between large (≥20 mm) ganglia and surrounding tissue and nerves was observed intraoperatively in 4 patients. Of the 8 patients, 7 underwent total ganglion resection. There were no surgery-related complications. On their last postoperative visit, 3 patients with a duration of symptoms not exceeding 10 months reported favorable outcomes.
Conclusions: Because ganglia eliciting TTS are often undetectable by skin palpation, imaging studies may be necessary. Early surgical intervention appears to yield favorable outcomes.
J Nippon Med Sch 2024; 91: 114-118
Keywords
ganglion, outcome, plantar nerve, surgery, tarsal tunnel syndrome
Correspondence to
Kenta Koketsu, MD, PhD, Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
kenta7240031@nms.ac.jp
Received, June 27, 2023
Accepted, October 4, 2023
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