The predictive power of cross-sectional area and intraneural blood flow measured by ultrasound on surgical outcomes will be tested.

Intraneural blood flow will be evaluated using power Doppler ultrasonography at the level of the carpal tunnel inlet. The presence and degree of intraneural vascularity will be graded using a semi-quantitative scoring system:

0 = No detectable intraneural flow

1. = Single vessel signal
2. = Multiple vessel signals
3. = Marked hypervascularity

The total score ranges from 0 to 3. Higher scores indicate increased intraneural vascularity.

The cross-sectional area of the median nerve will be measured using ultrasonography at the level of the pisiform bone (carpal tunnel inlet) and proximal to transvers carpal ligament. Measurements will be obtained by tracing the inner border of the hyperechoic epineurium.

Values will be recorded in square millimeters (mm²). Higher values indicate greater nerve swelling.

Change in Symptom Severity Score of the Boston Carpal Tunnel Questionnaire The Boston Carpal Tunnel Questionnaire is a patient-reported outcome measure consisting of 11 questions assessing symptom severity. Each item is scored from 1 (no symptoms) to 5 (most severe symptoms). The total score ranges from 11 to 55. Higher scores indicate worse symptom severity.