Mini-Open Carpal Tunnel Release with a Pediatric Nasal Speculum: A 10-Year Retrospective Case Series

Abstract

Background Nasal speculum assisted carpal tunnel release (CTR) is performed using smaller incisions than are normally achieved with open procedures. We performed a retrospective case series analysis to evaluate short and long-term symptom and functional outcomes of a single surgeon’s results with this technique. Methods During the period of 2005-2011, 678 cases met the inclusion criteria. Of these, 198 cases representing 152 unique individuals were contacted and consented to participate in the study. A chart review was performed to identify demographics, pre-operative questionnaire results, and post-operative characteristics. Post-operative Symptom Severity Scale and Functional Status Scale results from the Carpal Tunnel Questionnaire were then obtained via telephone interviews. Results The mean (StDev) time to follow up was 4.08 (2.1) years with the mean age at follow up 61.94 (14) years. More females (56%) were included than males (44%). Using linear mixed models, patients with nasal speculum assisted CTR had significant improvements in both Symptom Severity and Functional Status Scales following surgery. In addition, 97.7% of patients reported their incisions were aesthetically pleasing and only 78.7% reported their incisions were still visible. Several pre-operative factors had a significant association with good surgical outcomes, including: Positive Compression Test/Durkin’s; Severe/very severe difficulties on the Functional Status Scale; High scores on the Symptom Severity and Functional Status Scales. Conclusions This surgeon’s experience with nasal speculum assisted CTR shows that this technique results in not only aesthetically pleasing results, but also excellent symptomatic and functional outcomes. Level of Evidence Level IV Case Series