Hand Surgery and MicrosurgeryBenign Peripheral Nerve Tumors Treatment Algorithm and Reconstructive OptionsDucic, Ivica MD, PhD*; Barrett, Daniel M. MS†; Al-Attar, Ali MD, PhD*Author Information From the *Department of Plastic Surgery, Georgetown University Hospital, Washington, DC; and †Virginia Commonwealth University, School of Medicine, Richmond, VA. Received April 15, 2008, and accepted for publication, after revision, August 5, 2008. Reprints: Ivica Ducic, MD, PhD, Department of Plastic Surgery, Chief, Peripheral Nerve Surgery, Georgetown University Hospital, 1st Floor PHC Building, 3800 Reservoir Rd, NW, Washington, DC 20007. E-mail: [email protected]. Annals of Plastic Surgery: August 2009 - Volume 63 - Issue 2 - p 156-161 doi: 10.1097/SAP.0b013e318189389e Buy Metrics Abstract Peripheral nerve tumors are mostly benign; however, their excision can result in profound deficits. Nerve reconstruction strategies offer techniques to minimize morbidity. In this prospective study, 20 consecutive patients with benign peripheral nerve tumors were treated using a single-stage surgical paradigm between 2003 and 2007. Nerve fascicles were microdissected off of the tumor; any fascicle that gave origin to the tumor (was inseparable from tumor) was reconstructed using nerve conduits. Patients were followed from 6 to 24 months. All patients had neuropathic pain before tumor excision; only 1 patient had pain persist postoperatively. Seventeen patients had complete functional recovery after nerve reconstruction. No perioperative complications occurred. Benign peripheral nerve tumors require highly specialized surgical care. Tumor excision with immediate nerve reconstruction, for fascicles inseparable from the tumor, optimizes outcomes. Nerve reconstruction with available conduits or allografts should be attempted to restore anatomic integrity to any killed fascicles, thereby minimizing possible deficits. © 2009 Lippincott Williams & Wilkins, Inc.