Nimodipine and Acceleration of Functional Recovery of the Facial Nerve
                        After Crush Injury

Lindsay, Robin W.; Heaton, James T.; Edwards, C.; Smitson, Christopher; Hadlock, Tessa A.

doi:10.1001/archfaci.2009.95

Cited by 12 publications

(1 citation statement)

References 29 publications

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“…The current gold standard treatment for such segmental nerve injuries larger than 1 cm involves bridging the proximal and distal ends of the nerve with an autograft tissue. However, harvesting an autograft tissue is an invasive procedure, and it requires sacrificing a functional sensory nerve causing sensory loss at the donor site. , Even with treatment, regeneration is slow, extending up to 18 months, and full functional recovery is not achieved, resulting in asymmetric smile, oral incompetence, or lagophthalmos with potential for corneal injury. − In addition, due to the structure of their microanatomy, facial nerves are highly susceptible to synkinesis, in which the voluntary movement of one muscle leads to the involuntary movement of another muscle such as involuntary squinting of the eye as a patient attempts to smile. , Synkinesis is a result of axonal misdirection where regenerating axons branch and extend in aberrant directions, thus innervating incorrect postsynaptic targets. Correspondingly, axonal misdirection causes a reduced axonal density at the correct end organ, which contributes to reduced functional recovery.…”

Section: Introductionmentioning

confidence: 99%

Promoting and Orienting Axon Extension Using Scaffold-Free Dental Pulp Stem Cell Sheets

Drewry

Dailey

Rothermund

et al. 2022

ACS Biomater. Sci. Eng.

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Current treatments of facial nerve injury result in poor functional outcomes due to slow and inefficient axon regeneration and aberrant reinnervation. To address these clinical challenges, bioactive scaffold-free cell sheets were engineered using neurotrophic dental pulp stem/progenitor cells (DPCs) and their aligned extracellular matrix (ECM). DPCs endogenously supply high levels of neurotrophic factors (NTFs), growth factors capable of stimulating axonal regeneration, and an aligned ECM provides guidance cues to direct axon extension. Human DPCs were grown on a substrate comprising parallel microgrooves, inducing the cells to align and deposit a linearly aligned, collagenous ECM. The resulting cell sheets were robust and could be easily removed from the underlying substrate. DPC sheets produced NTFs at levels previously shown capable of promoting axon regeneration, and, moreover, inducing DPC alignment increased the expression of select NTFs relative to unaligned controls. Furthermore, the aligned DPC sheets were able to stimulate functional neuritogenic effects in neuron-like cells in vitro. Neuronally differentiated neuroblastoma SH-SY5Y cells produced neurites that were significantly more oriented and less branched when cultured on aligned cell sheets relative to unaligned sheets. These data demonstrate that the linearly aligned DPC sheets can biomechanically support axon regeneration and improve axonal guidance which, when applied to a facial nerve injury, will result in more accurate reinnervation. The aligned DPC sheets generated here could be used in combination with commercially available nerve conduits to enhance their bioactivity or be formed into stand-alone scaffold-free nerve conduits capable of facilitating improved facial nerve recovery.

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