The Retrospective Study Of The Treatment Of Radiation-induced Brachial Plexopathy

Objective: To explore the curative effect of myocutaneous flapstransplant after neurolysis, which were used to treat theradiation-induced brachial plexopathy. Methods: Retrospectively, 10cases with radiation-induced brachial plexopathy were selected asobjective group, which were treated in our department between Sep.1997 and Feb. 2006. These 9 cases were analysis contrastively at thepoints of the period between symptom appearance and diagnosis, theimportant clinical manifestation and sign, conservative treatment,surgical intervention and the result of following up. Result: 10 caseswith radiation-induced brachial plexopathy, 8 cases were followed upfor a period of 1 month to 8 years, with an average of 37.9 months,1case did not undergoing any treatment, 1 case were dead. The painrelief and function recovery were concerned. 2 cases were undergoingonly neurolysis, 1 of these was no obvious improvement, and the otherone was getting worse. 5 cases were treated with latissimus dorsimyocutaneous flaps after neurolysis, 3 of these were improvedobviously, 1 was no obvious improvement, the other one was dead. 2cases were treated with pectoralis major myocutaneous flap afterneurolysis, 1 of these was improved obviously, the other one was wasno obvious improvement. The latent period after radiation of the groupwith obvious improvement was longer, and the the period betweensymptom appearance and diagnosis was shorter. Conclusion: Sensorysymptoms, such as numbness, paresthesia, and dysesthesia, along withswelling and weakness of the arm, are the predominant presentingsymptoms in early days. The patient with radiation-induced brachialplexopathy usually present negative of Horner'sign. The curativeeffect can be enhanced when the delitescence after actinotheraphy islong or the period between symptom appearance and diagnosis is short.The procedure of covering the wounds with transferred myocutaneousflaps after neurolysis of the brachial plexus may improve the bloodsupply of the fibrotic brachial plexus by reestablishing a good nervebed. The procedure can relieve the symptom, improve the quality oflife.