Index
They tend to be benign (that is, not cancerous), but involve thickening of the nerve tissues.
A neuroma (/ njʊəroʊmə /; plural: neuromata or neuromas) is a growth or tumor of nervous tissue.
Many nerve tumors , including those that are commonly malignant, are known today by other terms.
This thickening, which can occur anywhere in the body, often causes severe nerve pain.
Touching it produces a sensation of radiant electrical shock in the distribution of the nerve
It can also interfere with the way you interpret touch and therefore lead to allodynia , dysesthesia, and hypersensitivity, all of which can be painful and uncomfortable.
Causes
Neuromas can arise from different types of nerve tissue, including nerve fibers and their myelin sheath, as in the case of genuine neoplasms (tumors) such as ganglioneuromas and neurinomas.
The term is also used to refer to any swelling of a nerve, even in the absence of abnormal cell growth.
In particular, traumatic neuroma is the result of trauma to a nerve, often during a surgical procedure.
Morton’s neuroma affects the foot. They can be painful, or sometimes, as in the case of acoustic neuromas, they can lead to other symptoms. A lacerated nerve located anywhere in the body will form a neuroma.
In other words, anywhere in your body where a nerve is cut is prone to forming a painful neuroma. Keep in mind that not all neuromas are painful, but those that are recognized.
A neuroma is a ball of scar tissue and sprouts of axons. These axon buds represent the nerve’s attempt to regenerate.
Signs and symptoms
Symptoms vary depending on where the neuroma is in the body and whether it is affecting other nerves, tissues, or organs.
General symptoms can include pain, tingling, numbness, and a burning sensation. In the case of acoustic neuroma, a person’s hearing is affected.
Idea
A neuroma is a nerve tissue scar that typically forms on the branch of a sensory nerve after injury to that nerve.
They often occur in patients after surgical procedures such as abdominal or cranial operations, as a result of cuts and lacerations involving the nerves, and after amputations.
A neuroma can be anywhere in the body and can be benign or malignant. Some common types of neuroma include neuroma, acoustic neuroma, and Morton’s neuroma.
A neuroma often occurs as a knot in the region of a sensory nerve underlying a scar. These injuries can be very painful and affect almost any part of the body.
Neurinoma is a slow-growing neuroma found in the myelin sheath of the peripheral nervous system.
Acoustic neuroma is found in the skull and affects hearing. Morton’s neuroma is found in the foot. Another common term associated with neuroma is “traumatic neuroma.”
This refers to damage to the nerves as a result of injury, such as can occur during surgery. This is often near a scar on the body and can be painful.
It is also sometimes known as a pinched nerve:
Neuroma de Morton
It is not a benign tumor, but rather a thickening of the tissue that surrounds the digital nerve as it extends to the toes.
It is considered a nerve compression or entrapment, and is treated differently than a neuroma resulting from an operation or injury.
Traumatic neuroma
Thus, they are found at sites of trauma, in scars, and on amputation stumps. One case followed a human bite. This is an extremely rare phenomenon.
Circumscribed solitary neuroma
They are painless, slow, and slow-growing nodules that are usually found in middle-aged people. An extremely rare site of involvement is the penis.
Ganglioneuroma
Ganglioneuromas can be found on the skin in patients with neuroblastomas and mature secondary skin deposits, and in von Recklinghausen disease where ganglion cells have become entrapped by a neurofibroma.
Primary cutaneous ganglioneuromas are extremely rare. Most cases develop after birth, but a congenital lesion has been reported. They are clinically nondescript, but histologically distinctive.
Ganglioneuromas consist of mature ganglion cells, which are generally interspersed with bundles of spindle cells.
In one reported case, ganglion cells were separated from neuromatous elements.
The term “ganglion cell choristoma” has been used in rare cases with ganglion cells and no stromal component.
At the other end of the spectrum is a case with an abundant collagenous stroma containing scattered spindle cells and ganglion cells, a desmoplastic ganglioneuroma. Overlapping hyperkeratotic epidermal changes were reported in two cases.
Acoustic neuroma
It is a non-cancerous growth that develops in the eighth cranial nerve. Also known as the vestibulocochlear nerve, it connects the inner ear to the brain and has two different parts.
One part is involved in the transmission of sound; the other helps send balance information from the inner ear to the brain.
Sometimes called vestibular schwannomas or neurilemoma, they usually grow slowly over a period of years. Although they don’t actually invade the brain, they can push it away as they grow.
Larger tumors can press on nearby cranial nerves that control the muscles of facial expression and sensation. If tumors grow large enough to press on the brain stem or cerebellum, they can be fatal.
Diagnosis
It is first diagnosed through a physical exam. In some cases, you may need an X-ray, ultrasound, or MRI to confirm this diagnosis.
Treatment
Treatments for neuroma depend on the type, severity, and location of the neuroma.
The initial treatment of a neuroma is nonsurgical. (A general principle of medicine is to reserve surgery for conditions that cannot be treated with drugs or other non-invasive means.)
Depending on the location of the neuroma, some initial nonsurgical neuroma treatments include the following:
- Tricyclic antidepressants.
- Anticonvulsants
- Desensibilización.
- Electrical stimulation.
- Ultrasound.
- Corticosteroid injections.
Treatments may include cryogenic neuroablation, which uses very cold temperatures to interrupt the transmission of pain signals. Unfortunately, the effects of this treatment do not last.
Another treatment is decompression surgery. In this surgery, the tissue that is being compressed and causing problems for the patient is removed.
They often respond well temporarily to nerve blocks using local anesthetic agents, which numb the area, and doctors can use this as a diagnostic tool.
One of the treatments for neuromas is neurectomy or resection (removal) of the nerve tissue. The surgeon will identify the nerve branch that the neuroma has and cut this branch above the mass.
He or she will cauterize the end of the nerve and place the nerve in a position where a neuroma is much less likely to form.
Another treatment is to resect the neuroma and then graft from the proximal (closest) end of the nerve to an appropriate target.
Alternatively, the neuroma itself can sometimes be removed surgically. Other treatments to manage it include pain relievers and physical therapy.
Surgical procedure to treat a neuroma
A standard carpal incision is extended to the hand to identify neuromas in an amputated index finger. A second incision is made on the back (upper surface) to perform nerve repair between the nerve graft and the digital nerves.
Now let’s look at some specific examples of neuromas.
Neuroma in the hand
The superficial radial nerve in the hand is particularly prone to developing neuromas. The superficial radial nerve allows sensation in the back of the hand.
Those that affect the superficial radial nerve can be detected with the Tinel test, where a doctor touches the area above the nerve to cause a “tingling” sensation.
When nonsurgical treatments for superficial radial nerve neuroma fail, the neuroma can be resected or cut. However, a new one will sprout to take its place.
A better treatment for this type of neuroma is to bury it in a muscle or bone, which moves the neuroma away from the surface of the skin, where it can be affected and irritated. In other words, by hiding the neuroma, it is less likely to become irritated and painful.
Neuroma in the lower leg
During knee replacement or knee replacement, the infrapatellar branch of the saphenous nerve can be cut, resulting in a neuroma. The infrapatellar branch of the saphenous nerve supplies the skin overlying the patella or patella.
Forecast
Neuromas can occur after certain surgeries, such as a mastectomy or limb amputation, causing pain to persist long after the expected surgical healing time. This can lead to chronic postoperative pain.
The prognosis for neuroma varies greatly depending on the type, location, and severity. With early diagnosis and proper treatment, the prognosis can be very positive and people can live long and healthy lives.
