Facial nerve repair utilizing intraoperative repair strategies

Abstract

ObjectivesTo determine whether functional and anatomical outcomes following suture neurorrhaphy are improved by the addition of electrical stimulation with or without the addition of polyethylene glycol (PEG).MethodsIn a rat model of facial nerve injury, complete facial nerve transection and repair was performed via (a) suture neurorrhaphy alone, (b) neurorrhaphy with the addition of brief (30 minutes) intraoperative electrical stimulation, or (c) neurorrhaphy with the addition electrical stimulation and PEG. Functional recovery was assessed weekly for 16 weeks. At 16 weeks postoperatively, motoneuron survival, amount of regrowth, and specificity of regrowth were assessed by branch labeling and tissue analysis.ResultsThe addition of brief intraoperative electrical stimulation improved all functional outcomes compared to suturing alone. The addition of PEG to electrical stimulation impaired this benefit. Motoneuron survival, amount of regrowth, and specificity of regrowth were unaltered at 16 weeks postoperative in all treatment groups.ConclusionThe addition of brief intraoperative electrical stimulation to neurorrhaphy in this rodent model shows promising neurological benefit in the surgical repair of facial nerve injury.Level of EvidenceAnimal study.

Effects of electroactive materials on nerve cell behaviors and applications in peripheral nerve repair

“…In recent years, an increasing number of studies have applied electrical stimulation to promote peripheral nerve repair. 53,[70][71][72][73] For example, Brown et al 74 have compared the repair effect of suturing the nerve alone with that of applying half an hour of electrical stimulation to the nerve at the time of suturing and their results showed that the addition of brief intraoperative electrical stimulation could effectively improve all functional outcomes. Willand et al 75 have also applied electrical stimulation to the gastrocnemius muscle by implanting electrodes for 1 month after transection of the tibial nerve, and the results showed that the introduction of electrical stimulation was effective at reducing muscle atrophy.…”

“…87 Conductive materials can modulate cell-cell or cell-tissue interactions by mediating electrical charge transport at the interface of cell membranes, 87 and electrogenic materials can provide electrical stimulation to nerve cells or other types of cells to stimulate them to generate action potentials. 74,88 At present, many studies have confirmed that electroactive materials play an important role in peripheral nerve repair, such as the regulation of cell behaviors, signaling pathway, immune microenvironment, etc. A detailed overview is listed in Table 2.…”