Median Nerve Neuropathy following Radial Forearm Free Flap Phalloplasty: A Case Report

被引:6
|
作者
Jolly, Divya [1 ,2 ]
Chrisos, Haley A. [1 ,2 ]
Kaufman-Goldberg, Tal [2 ]
Ganor, Oren [1 ,2 ,3 ]
Taghinia, Amir H. [1 ,2 ,3 ]
机构
[1] Boston Childrens Hosp, Dept Plast & Oral Surg, Ctr Gender Surg, 300 Longwood Ave, Boston, MA 02215 USA
[2] Harvard Med Sch, Boston Childrens Hosp, Dept Plast & Oral Surg, Boston, MA 02115 USA
[3] Harvard Med Sch, Dept Surg, Boston, MA 02115 USA
关键词
PATIENT; COMPLICATIONS;
D O I
10.1097/GOX.0000000000003027
中图分类号
R61 [外科手术学];
学科分类号
摘要
As the transgender population increases, gender-affirming surgeries are being performed at unprecedented rates. Despite this increase, complications and long-term outcomes of gender-affirming interventions are largely understudied. We present a transgender patient who underwent radial forearm free flap (RFFF) phalloplasty as part of gender affirmation. Immediately following surgery, the patient reported paresthesia in the donor arm in the median nerve distribution followed by a neuropathic pain after 1 week. The patient complained of shooting and burning pain and reported a loss of sensation and function at the donor site. Electromyography and magnetic resonance imaging results indicated median nerve damage several inches above the donor site. The symptoms persisted for several months before spontaneously resolving. The spontaneous resolution and location of injury suggest that nerve damage occurred as a result of pneumatic tourniquet application despite adherence to all clinical guidelines for a safe tourniquet application of the same. This is the first reported case of neuropathic pain following RFFF phalloplasty occurring at the donor site. Given the large donor area and the long time of tourniquet application, surgeons offering RFFF phalloplasty must be aware of and actively counsel patients seeking this procedure about the potential for nerve-related damages before surgery.
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页数:3
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