Nerve Regeneration after Terminolateral Neurorrhaphy: Experimental Study in Rats

Zhao, Jin-zhong; Chen, Zhongwei; Chen, Tongyi

doi:10.1055/s-2008-1063938

Cited by 111 publications

(86 citation statements)

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“…Many authors subsequently confirmed that both sensory and motor nerves had reinnervated recipient nerves through collateral sprouting, through using this technique. [10][11][12] Furthermore, …”

Section: Discussionmentioning

confidence: 99%

Double muscle innervation using end-to-side neurorrhaphy in rats

et al. 2012

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CONTEXT AND OBJECTIVE: One of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation. DESIGN AND SETTING: Experimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp. METHODS: One hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy. RESULTS: One hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred. CONCLUSION: These findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned. RESUMO CONTEXTO E OBJETIVO:Uma das técnicas utilizadas para tratamento da paralisia facial é a dupla inervação muscular com neurorrafia término-terminal, seccionando-se nervos sadios. O objetivo deste trabalho foi avaliar a ocorrência de dupla inervação muscular através de neurorrafia término-lateral e a manutenção da inervação. TIPO DE ESTUDO E LOCAL: Estudo experimental desenvolvido no Centro de Pesquisa Experimental da Faculdade de Medicina de Botucatu, Unesp. MÉTODOS: Cem ratos foram distribuídos em cinco grupos: G1, controle; G2, secção do nervo fibular; G3, o nervo tibial foi seccionado e o coto proximal suturado na lateral do nervo fibular íntegro; G4, 120 dias após a cirurgia do G3, o nervo fibular foi seccionado proximal à neurorrafia; G5, 120 dias após a cirurgia do G3, os nervos fibular e tibial foram seccionados proximal à neurorrafia. RESULTADOS: Após 150 dias da cirurgia, não foi observada variação na massa do músculo tibial ou no diâmetro das fibras musculares no G3, porém, houve redução do diâmetro da fibra axonal do nervo fibular distal à neurorrafia. Embora, no G4, tenha ocorrido atrofia do músculo tibial cranial 30 dias após a secção do nervo fibular, os resultados do teste eletrofisiológico e da medida do diâmetro axonal confirmaram a ocorrência de reinervação muscular. CONCLUSÃO: Estes resultados sugerem que a dupla inervaç...

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Section: Discussionmentioning

confidence: 99%

Double muscle innervation using end-to-side neurorrhaphy in rats

et al. 2012

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“…51 Accordingly, the number of nerve fibers entering the recipient nerve from the mixed donor nerve was higher after making either an epineurial or perineurial window than after the nerve coaptation with epineurial suturing only, resulting in more effective muscle reinnervation during the first 3 months after end-to-side nerve coaptation. 12,13,29,[48][49][50]54 but not later from 4 up to 8 months after surgery. 16,51,53,64 Interestingly, if epineurial or perineurial windows were enlarged from 1 to 4 or 5 mm, respectively, then, also, the magnitude of axonal ingrowth into the recipient nerve was increased.…”

Section: Kovač Ič Et Almentioning

confidence: 99%

“…This suggests that at least the sprouting sensory axons are able to penetrate the perineurium and epineurium of the donor nerve. 46,47 Creating an epineurial or perineurial window in the donor nerve at the site of end-to-side nerve coaptation with sutures enhanced the sprouting of motor and sensory axons into the recipient nerve in some studies, 12,13,16,29,[48][49][50] but not in others. 35,[51][52][53][54] The effects of either epineurial or perineurial window on the axonal sprouting into the recipient nerve were directly compared in only two studies.…”

Section: Introductionmentioning

confidence: 99%

Influence of Breaching the Connective Sheaths of the Donor Nerve on Its Myelinated Sensory Axons and on Their Sprouting into the End-to-Side Coapted Nerve in the Rat

Kovačič

Žele²,

Tomšič³

et al. 2012

Journal of Neurotrauma

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The influence of breaching the connective sheaths of the donor sural nerve on axonal sprouting into the end-to-side coapted peroneal nerve was examined in the rat. In parallel, the effect of these procedures on the donor nerve was assessed. The sheaths of the donor nerve at the coaptation site were either left completely intact (group A) or they were breached by epineurial sutures (group B), an epineurial window (group C), or a perineurial window (group D). In group A, the compound action potential (CAP) of sensory axons was detected in *10% and 40% of the recipient nerves at 4 and 8 weeks, respectively, which was significantly less frequently than in group D at both recovery periods. In addition, the number of myelinated axons in the recipient nerve was significantly larger in group D than in other groups at 4 weeks. At 8 weeks, the number of axons in group A was only *15% of the axon numbers in other groups ( p < 0.05). Focal subepineurial degenerative changes in the donor nerves were only seen after 4 weeks, but not later. The average CAP area and the total number of myelinated axons in the donor nerves were not different among the experimental groups. In conclusion, myelinated sensory axons are able to penetrate the epiperineurium of donor nerves after end-to-side nerve coaption; however, their ingrowth into recipient nerves is significantly enhanced by breaching the epiperineurial sheets at the coaptation site. Breaching does not cause permanent injury to the donor nerve.

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“…In fact, when there is no injury to the donor nerve, nerve regeneration can occur following endto-side anastomosis, but several experimental studies have shown that when the donor nerve had a fenestration, the effect of nerve regeneration was better [71][72][73][74]. Although there are still controversies over whether fenestration can damage the donor nerve, many studies have confirmed that the fenestration of the epineurium can cause a slight damage to the donor nerve, but does not affect the donor nerve function [75][76][77].…”

Section: Epineurium or Perineurium Windowmentioning

confidence: 99%