Karpal Tünel Sendromunda N. Medianus’un ENMG ile Değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Nervus medianus, plexus brachialis’in fasciculus lateralis’inden ayrılan radix lateralis nervi
mediani ile fasciculus medialis’inden gelen radix medialis nervi mediani’nin birleşmesiyle oluşur.
Retinaculum musculorum flexorum’un altından canalis carpi yoluyla geçerek elin ön yüzüne gelir.
Kanaldan geçtikten sonra ya da kanal içinde uç dallarına ayrılır. Karpal tünel sendromu (KTS), nervus
medianus’un elde ossa carpalis ile aponeurosis palmaris arasından geçişi sırasında sıkışmasına bağlı
olarak ortaya çıkan klinik tablodur. Elektromiyografi (EMG), sinir ve çizgili kasların elektrik
potansiyelinin incelenmesine dayanan bir nörolojik tetkik yöntemidir ve karpal tünel sendromunun
kesin tanısında kullanılır.
Bu çalışmada, KTS olan bireylerde ve kontrol grubunda n. medianus’un iletim kalitesinin ve
anatomik yapısının elektronöromyografi bulguları üzerinden değerlendirilmesi amaçlandı.
Çalışmamızda 2-8. dekatlar arasındaki yaş grubunda 347 birey ve 694 üst ekstremite
incelendi. Bireylerin elektronöromyografi raporları KTS düzeylerine göre duyu ve motor latans ve
durasyon bakımından retrospektif olarak incelendi. Veriler n. medianus’un iletim kalitesi ve Martin
Gruber anastomozu varlığı açısından değerlendirildi.
Değerlendirme sonuçlarımıza göre bireylerin %27,66’sında her iki ekstremitede KTS vardı.
Bireylerin %8,64’ünde sadece sağ, %2,88’inde sadece sol ekstremitede KTS vardı. Latans
ortalamalarının farkları incelendiğinde KTS’li kişilerde istatistiksel olarak anlamlıydı (p<0,05).
Amplitüd oranlarına bakıldığında ise KTS düzeylerinde istatistiksel olarak anlamlı olduğu (p<0,05)
görüldü. Her iki ekstremitede anastomoz varlığı incelendiğinde ise bilateral anastomoz görülme sıklığı
%9,51, her iki ekstremitede bilateral olarak anastomoz olmaması %57,06 olarak belirlenmiştir. KTS
düzeylerine göre n. ulnaris ve n. medianus’un duyusal ve motor amplitüd ve latans değerlerinin
oranları incelendiğinde başlangıç seviyesinde ve orta seviyede KTS olan kişilerde amplitüd ve latans
değerleri istatistiksel olarak anlamlıydı (p<0,05). N. medianus’un aynı ekstremitede birden fazla
anastomoz tipine uyum göstermesi (%4,89) n. medianus ve n. ulnaris arasında farklı lif bağlantılarının
da olduğunu gösterdi. N. medianus’un iletim kalitesinin ve anastomoz bilgilerinin KTS tedavisi ve el
cerrahilerinde önem arz ettiğini düşünmekteyiz.
Nervus medianus is formed by the combination of radix lateralis nervi mediani, which separates from the fasciculus lateralis of plexus brachialis, and radix medialis nervi mediani from fasciculus medialis. Median nerve passes under the retinaculum musculorum flexorum through the carpal tunnel and comes to the front of the hand. It is divided into end branches after passing through the canal or in the canal. Carpal tunnel syndrome (CTS) is the clinical picture that occurs due to compression of the nervus medianus during the passage of hand between the carpal bones and aponeurosis palmaris. Electromyography (EMG) is a neurological examination method based on the examination of the electrical potential of nerve and striated muscles and is used in the definitive diagnosis of carpal tunnel syndrome. In this study, in individuals with carpal tunnel syndrome and in the control group. It was aimed to evaluate the transmission quality and anatomical structure of median nerve based on electroneuromyography findings. In our study, 347 people and 694 upper extremities were examined in the age group between 2-8. decades. Electroneuromyography reports of individuals were analyzed retrospectively in terms of sensory and motor latency and duration according to carpal tunnel syndrome levels. Data analyzed respect to transmission quality of median nerve and the presence of Martin Gruber anastomosis were evaluated. According to our evaluation results, 27.66% of individuals had CTS in both extremities. CTS was found in only the right extremity in 8.64% of the individuals and only in the left limb in 2.88% (p<0.05). When the amplitude rates were analyzed, it was seen that it was statistically significant (p <0.05) in the patients of carpal tunnel syndrome. When the presence of anastomosis was examined in both extremities, the frequency of bilateral anastomosis was determined as 9.51%, and the absence of anastomosis in both extremities as 57.06%. According to KTS levels the ratios of sensory and motor amplitude and latency values of median nerve and ulnar nerve were analyzed, amplitude and latency values were statistically significant in people with baseline and moderate CTS (p <0.05). We think offered for CTS treatment to the compatibility of median nerve with more than one type of anastomosis on the same limb (4,89%) showed that there were different fiber connections between median nerve and ulnar nerve.
Nervus medianus is formed by the combination of radix lateralis nervi mediani, which separates from the fasciculus lateralis of plexus brachialis, and radix medialis nervi mediani from fasciculus medialis. Median nerve passes under the retinaculum musculorum flexorum through the carpal tunnel and comes to the front of the hand. It is divided into end branches after passing through the canal or in the canal. Carpal tunnel syndrome (CTS) is the clinical picture that occurs due to compression of the nervus medianus during the passage of hand between the carpal bones and aponeurosis palmaris. Electromyography (EMG) is a neurological examination method based on the examination of the electrical potential of nerve and striated muscles and is used in the definitive diagnosis of carpal tunnel syndrome. In this study, in individuals with carpal tunnel syndrome and in the control group. It was aimed to evaluate the transmission quality and anatomical structure of median nerve based on electroneuromyography findings. In our study, 347 people and 694 upper extremities were examined in the age group between 2-8. decades. Electroneuromyography reports of individuals were analyzed retrospectively in terms of sensory and motor latency and duration according to carpal tunnel syndrome levels. Data analyzed respect to transmission quality of median nerve and the presence of Martin Gruber anastomosis were evaluated. According to our evaluation results, 27.66% of individuals had CTS in both extremities. CTS was found in only the right extremity in 8.64% of the individuals and only in the left limb in 2.88% (p<0.05). When the amplitude rates were analyzed, it was seen that it was statistically significant (p <0.05) in the patients of carpal tunnel syndrome. When the presence of anastomosis was examined in both extremities, the frequency of bilateral anastomosis was determined as 9.51%, and the absence of anastomosis in both extremities as 57.06%. According to KTS levels the ratios of sensory and motor amplitude and latency values of median nerve and ulnar nerve were analyzed, amplitude and latency values were statistically significant in people with baseline and moderate CTS (p <0.05). We think offered for CTS treatment to the compatibility of median nerve with more than one type of anastomosis on the same limb (4,89%) showed that there were different fiber connections between median nerve and ulnar nerve.
Açıklama
Anahtar Kelimeler
anastomoz, elektromyografi, karpal tünel sendromu, n. medianus, Anastomosis, carpal tunnel syndrome, electromyography, median nerve
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Şirin, B. Y., (2020). Karpal Tünel Sendromunda N. Medianus’un ENMG ile Değerlendirilmesi. (Yüksek Lisans Tezi). Selçuk Üniversitesi, Sağlık Bilimler Enstitüsü, Konya.
