Long Term Safety of Preoperative Percutaneous Intercostal Cryoneurolysis: Neuropathic Pain, Quality of Life and Sensory Recovery in a Paediatric Cohort Following Pectus Excavatum Repair

Assessment tools include validated questionnaires (S-LANSS and PedsQL) and a structured physical examination of thoracic sensitivity. These tools are administered at pre-specified follow-up appointments (timepoints). The sensory physical examination is conducted using four standardized stimuli, selected to systematically assess each class of afferent nerve fibers of the intercostal nerves. For cold thermal sensation (Aδ fibers), a latex glove containing an ice-water mixture (4-10°C) is applied in contact with the skin over predetermined anterior thoracic areas. For warm thermal sensation (unmyelinated C fibers), an analogous container filled with water at approximately 40°C, heated using a bottle warmer, is employed. Tactile sensitivity (Aβ fibers) is assessed using a standardized camel-hair neurological brush for light touch, and Von Frey filaments (5.07/10 grams) for pressure sensitivity.