| Traumatic neuroma | |
|---|---|
| Other names | Amputation neuroma or Pseudoneuroma[1] |
 | |
| Specialty | Neurology |
A traumatic neuroma is a type of neuroma which results from trauma to a nerve, usually during a surgical procedure. The most common oral locations are on the tongue and near the mental foramen of the mouth.[2] They are relatively rare on the head and neck.[3]
An essential step in the formation of a traumatic neuroma is injury to the perineurium. The perineum directs the growth of axons by acting as a surface that the axons cannot go through. If the perineurium is compromised, the axons may escape into the extraperineural space and arborize in an unregulated fashion.[4]
Many surgeries have nerve injury as an unavoidable consequence such as limb amputation, nerve resections, or radical prostatectomy. Consequently, surgical techniques to reduce accidental nerve injury (nerve sparing techniques)[5][6] and reduce the likelihood to develop traumatic neuromas[7] have been researched. Targeted muscle reinnervation (TMR) is a promising technique used clinically that has significantly improved various benchmarks of quality of life such as pain free patients, residual limb pain, phantom limb pain, opioid use, and ambulation.[8] TMR involves the transfer of proximal nerve stumps to nearby muscle and was originally developed to improve prosthetic control. A newer, related technique is taking a muscle graft and moving it to the divided end of the peripheral nerve, called a regenerative peripheral nerve interface (RPNI). RPNI also significantly reduces the incidence of neuroma formation for amputation.[9]