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Intraoperative intravenous fluorescein as an adjunct during surgery for peroneal intraneural ganglion cysts

  • Technical Note - Peripheral Nerves
  • Published:
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Abstract

The intraoperative use of intravenous fluorescein is presented in a case of peroneal intraneural ganglion cyst. When illuminated with the operative microscope and yellow filter, this fluorophore provided excellent visualization of the abnormal cystic peroneal nerve and its articular branch connection. The articular (synovial) theory for the pathogenesis of intraneural cysts is further supported by this pattern of fluorescence. Further, our report presents a novel use of fluorescein in peripheral nerve surgery.

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Author information

Authors and Affiliations

  1. Department of Neurologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Jonathan J. Stone, Christopher S. Graffeo & Robert J. Spinner

  2. Department of Neurosurgery, Hague Medical Center, The Hague, The Netherlands

    Godard C.W. de Ruiter

  3. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Michael G. Rock

Authors
  1. Jonathan J. Stone
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  2. Christopher S. Graffeo
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  3. Godard C.W. de Ruiter
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  4. Michael G. Rock
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  5. Robert J. Spinner
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Corresponding author

Correspondence to Robert J. Spinner.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee (Mayo Clinic Institutional Review Board) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study, formal consent was not required.

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Comments

A well-written and illustrated case report demonstrating the novel intraoperative use of the dye, fluroscein, to preferentially accumulate in the intraneural ganglion cyst portion of the common personal (ie the deep branch) as well as in the feeding articular branch supplying the tibiifibular joint space. In addition to further supporting the articular branch theory of intraneural cyst formation, it also supplied the nerve surgeon with an additional way to locate and confirm the identity of the articular nerve branch. It will be interesting to see what other peripheral nerve applications this technique will have.

Michel Kliot

CA, USA

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Stone, J.J., Graffeo, C.S., de Ruiter, G.C. et al. Intraoperative intravenous fluorescein as an adjunct during surgery for peroneal intraneural ganglion cysts. Acta Neurochir 160, 651–654 (2018). https://doi.org/10.1007/s00701-018-3477-0

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  • DOI: https://doi.org/10.1007/s00701-018-3477-0

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