Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Pereira, Clifford T.; Hill, Elise E.; Stasyuk, Anastasiya; Parikh, Neil; Dhillon, Jannat; Wang, Aijun; Li, Andrew

doi:10.3390/jcm12041555

Cited by 3 publications

(1 citation statement)

References 63 publications

(160 reference statements)

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“…The property of being tension-free is crucial to a successful coaptation as it allows for faster axonal sprouting and final growth into motor nerve endplates. 11 In cases of doubt, alternating dorsiflexion and plantar flexion of the foot can help with visualization of muscle displacement and whether coaptation is adequate to ensure tension-free coaptation.…”

Section: Methodsmentioning

confidence: 99%

Management of Superficial and Deep Peroneal Nerve Neuromas with Targeted Muscle Reinnervation in Nonamputees: Operative Technique and Early Outcomes

Moradian,

Taritsa,

Sharma

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Targeted muscle reinnervation (TMR), a surgical technique developed by the senior authors that coapts proximal ends of nerves to distal motor nerves of adjacent muscles, has demonstrated efficacy in the treatment and prevention of neuroma pain. The objective of this study is to describe the surgical technique for TMR of the superficial peroneal nerve (SPN) and deep peroneal nerve (DPN) in nonamputee patients and provide data on postoperative functional outcomes. Methods: A single-institution retrospective chart review was performed between March 2018 and April 2021. Patients were de-identified and included if they were nonamputees receiving TMR for pain in the peroneal nerve distribution. Data extracted included demographic information, symptoms before operation, relevant nerve coaptation, peri-, and postoperative complications, and long-term functional outcomes. Results: Of the 19 patients reviewed, 11 patients underwent TMR of the SPN alone: eight had complete resolution of their symptoms; two indicated partial improvement in pain; and one patient had no improvement. Four patients underwent TMR of the DPN alone: two patients had complete resolution of their pain, and two patients had partial improvement with pain. Four patients underwent TMR of both the SPN/DPN: two patients had complete resolution of their symptoms, and two patients were noted to have significant improvement but had persistent pain from prior foot operations. Average follow-up time was 260 days. Conclusions: TMR is a successful technique in the management of SPN and DPN neuroma pain. Our technique revealed excellent clinical outcomes, no procedure-specific complications, and improved subjective pain reports.

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Section: Methodsmentioning

confidence: 99%

Management of Superficial and Deep Peroneal Nerve Neuromas with Targeted Muscle Reinnervation in Nonamputees: Operative Technique and Early Outcomes

Moradian,

Taritsa,

Sharma

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Management of facial nerve trauma

Greiner,

Kohlberg,

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review To present the current literature on management of facial nerve disorder secondary to trauma, with a focus on the utility of electrodiagnostic testing in this setting. Recent findings Patients with facial palsy related to temporal bone fractures should be started on high-dose corticosteroids as early as possible. Recent literature on the benefit of surgical intervention in the setting of temporal bone fracture is mixed. Some studies support early surgical decompression whereas others have found no benefit compared with conservative treatment. Summary The management of facial nerve trauma is based on location and extent of injury. Extratemporal trauma and transected nerve should be treated with surgical exploration and tension-free coaptation ideally within 72 h. There are no guidelines for intratemporal facial nerve trauma. Surgical decompression compared with medical management is debated in the literature without consensus and more large studies are needed.

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Peripheral nerve injury: molecular pathophysiology and prospects for restorative treatment by means of cell transplantation: a literature review

Melikov,

Medvediev

2023

Ukr Neurosurg J

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Peripheral nerve injury (PNI) is a fairly common pathology—PNI accounts for 1-5% of all peacetime injuries and 12% of all combat injuries. This injury leads to disability, the development of chronic pain syndromes and a significant deterioration in the quality of life of the victims. Unfortunately, at present, in the case of the most frequent type of combat trauma — damage to the limbs — PNI treatment is mostly done last, "on the residual principle." Modern means of surgical and conservative treatment of PNI do not provide complete restoration of lost functions, therefore, restorative treatment of PNI is an urgent biomedical problem. The article reviews the currently known molecular mechanisms of various stages of PNI, as well as the plasticity of the central parts of the nervous system on the background of this injury. The main reasons for the limitation of autogenous recovery of functions after a sustained PNI are described — the absence of a relevant spatial organization of regrowth of axons in the area of PNI; post-traumatic death of neurons of spinal nodes and central parts of the nervous system; failure of plastic reconstruction of brain and spinal cord neural networks; irreversibility of atrophy of denervated muscles. Based on this, it was established that the means of restorative treatment of PNI should touch not only the epicenter of PNI, but also the central parts of the nervous system and denervated muscles. Mesenchymal stem cells (MSCs) are well-known means of a positive influence on the the restorative process in the focus of PNI, as well as a source of supportive influence/ strengthening effect and an amplifier of the plasticity of brain neural networks, which makes these cells a promising element of bioengineering treatment of PNI. The effect of MSCs on the central parts of the nervous system in case of PNI remains the least studied. Data from the literature indicate that such an effect can provide support for secondarily affected neurons and stimulate the plastic reorganization of brain networks, i.e., in general, significantly improve the results of restorative treatment of PNI.

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Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Cited by 3 publications

References 63 publications

Management of Superficial and Deep Peroneal Nerve Neuromas with Targeted Muscle Reinnervation in Nonamputees: Operative Technique and Early Outcomes

Management of Superficial and Deep Peroneal Nerve Neuromas with Targeted Muscle Reinnervation in Nonamputees: Operative Technique and Early Outcomes

Management of facial nerve trauma

Peripheral nerve injury: molecular pathophysiology and prospects for restorative treatment by means of cell transplantation: a literature review

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