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Background: Carpal tunnel syndrome (CTS) results from compression of the median nerve at the wrist. Intermittent compression of the nerve results in numbness and parasthesias. Surgical treatment is generally recommended in cases that fail to respond to conservative measures. A variety of surgical techniques have been described for the treatment of carpal tunnel syndrome. The open incision technique has some disadvantages related to the procedure. So, Recent studies aim to decrease these complications by mini open incisions. Performing a mini incision technique by using nasal instruments has tremendous advantages and very satisfying results. Objective: To assess the feasibility of the mini incision technique using nasal instruments to release carpal tunnel. Methods: In this study, we performed a mini incision technique by using nasal instruments to 20 hands of patients suffering of carpal tunnel syndrome. We included all patients with carpel tunnel syndrome with positive conduction studies. We exclude the patients with cervical radiculopathy, recurrent CTS, and the Patients having CTS, due to traumatic fracture. We used a symptoms score called 6 item score. That depends on pain severity tingling and numbness severity at day time and at night, preoperative and postoperative, awakening at night due to pain or tingling preoperative and postoperative .We also compared between tinnel's test, phalen's test, motor velocity and latency and sensory latency preoperative and postoperative, no major complications occurred (recurrence, injuries) at the time of the study, minor complications however, were quite common and included delayed healing, postoperative pain that required analgesics. Results: In cases of a carpel tunnel syndrome, modified open technique by ISSN: 2536-9474 (Print) Original article / FYMJ ISSN: 2536-9482 (Online) Fayoum University Medical Journal Mikhail et al., 2020,6(1), 36-54 Page 37 a mini incision technique by using nasal instruments less time was consumed than other techniques, reasonable exposure rates and more easy to cut the transverse carpal ligament safely unless very thick tough or calcified, greatly improves all symptoms like pain severity tingling and numbness severity at day time and at night and awakening times at night due to pain or tingling,and improves the nerve function and conductivity studies as tinnel test, phalen test, motor velocity and latency and sensory latency. No injury to any of the structures had occurred and no patient came back for revision, and all patients had symptoms relieved. Conclusion: In cases of a carpel tunnel syndrome, modified open technique by a mini incision technique by using nasal instruments having satisfying results, greatly improves all symptoms like pain severity tingling and numbness severity at day time and at night. No major complications like recurrence nor injuries occured.

Carpal Tunnel Release Using Nasal Instruments