The Comparison of Histological Results of Experimentally Created Facial Nerve Defects Repaired by 2 Different Anastomosis Techniques

Gencer, Zeliha Kapusuz; Özkırış, Mahmut; Saydam, Levent; Dağlıoğlu, Yusuf Kenan; Sakallıoğlu, Öner; Kuyucu, Yurdun; Polat, Sait; Kanmaz, Alper

doi:10.1097/scs.0000000000000605

Cited by 9 publications

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“…Introduction of cyanoacrylates in both experimental and clinical practice has stimulated researchers’ curiosity, and has been applied to end-to-side nerve repair, but with debatable outcomes, whether questioned [ 43 , 48 ] or not [ 44 , 45 , 46 , 47 ]. Some recent experiences [ 103 ] are based on the debatable premise that cyanoacrylate produce inflammation and scar in the coaptation site.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Cyanoacrylates are a group of substances well-known and tested for their gluing properties and to date available for clinical use [ 43 , 44 , 45 , 46 , 47 , 48 ]. Restrictions to their use in nerve coaptation have been registered by some authors [ 43 , 48 ], who detected that uncontrolled contamination by the gluing agent of the coapted nerve surfaces could produce local inflammation and a scar wall stopping nerve fibre regeneration. However, their findings have been questioned by other studies, demonstrating that a transient inflammatory effect produced by cyanoacrylate in the coaptation zone is capable to stimulate local ingrowth of Schwann cells and connective tissue, creating the way for axonal sprouting [ 44 , 45 , 46 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

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Epineurial Window Is More Efficient in Attracting Axons than Simple Coaptation in a Sutureless (Cyanoacrylate-Bound) Model of End-to-Side Nerve Repair in the Rat Upper Limb: Functional and Morphometric Evidences and Review of the Literature

et al. 2016

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End-to-side nerve coaptation brings regenerating axons from the donor to the recipient nerve. Several techniques have been used to perform coaptation: microsurgical sutures with and without opening a window into the epi(peri)neurial connective tissue; among these, window techniques have been proven more effective in inducing axonal regeneration. The authors developed a sutureless model of end-to-side coaptation in the rat upper limb. In 19 adult Wistar rats, the median and the ulnar nerves of the left arm were approached from the axillary region, the median nerve transected and the proximal stump sutured to the pectoral muscle to prevent regeneration. Animals were then randomly divided in two experimental groups (7 animals each, 5 animals acting as control): Group 1: the distal stump of the transected median nerve was fixed to the ulnar nerve by applying cyanoacrylate solution; Group 2: a small epineurial window was opened into the epineurium of the ulnar nerve, caring to avoid damage to the nerve fibres; the distal stump of the transected median nerve was then fixed to the ulnar nerve by applying cyanoacrylate solution. The grasping test for functional evaluation was repeated every 10–11 weeks starting from week-15, up to the sacrifice (week 36). At week 36, the animals were sacrificed and the regenerated nerves harvested and processed for morphological investigations (high-resolution light microscopy as well as stereological and morphometrical analysis). This study shows that a) cyanoacrylate in end-to-side coaptation produces scarless axon regeneration without toxic effects; b) axonal regeneration and myelination occur even without opening an epineurial window, but c) the window is related to a larger number of regenerating fibres, especially myelinated and mature, and better functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epineurial Window Is More Efficient in Attracting Axons than Simple Coaptation in a Sutureless (Cyanoacrylate-Bound) Model of End-to-Side Nerve Repair in the Rat Upper Limb: Functional and Morphometric Evidences and Review of the Literature

et al. 2016

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“…For this purpose bio-resorbable suture material and biocompatible nanofibers are currently used [125]. The alternative to nerve suture is biological glue which was more effective than traditional stitches when connecting stumps [126,127]. Efforts were also made to combat the growth of collagen in sutures and nerve neuromas [128][129][130].…”

Section: Chapter 4 Nerve Fiber Trauma and The Retraction Of Axoplasmmentioning

confidence: 99%

Properties Live Axoplasm

2015

Single Cell Biol

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This book is devoted to the study of physiological properties of a living axoplasm, which, as it turns out, is rarely studied as a single organ. This study revealed a number her new physiological properties. The mechanism of simultaneous currents, bidirectional axoplasm, disappearance streams and reappearance of the apical dendrites of pyramidal neurons in the brain during stress were revealed, as well as the causes of the similarity of nerve terminals regardless of their very different physiological functions. There exists proof of differences in presynaptic terminals of the postsynaptic. The reasons for the impossibility of treating transected axons using surgical sutures are discussed, and finally the cause of the absence of swelling properties in myelinated fibers with hypotension environment is solved. Some new approaches to the treatment of fibers, early manifestations of diastase nonspecific reactions,and Schmidt-Lanterman clefts.

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“…A cola de fibrina, constituída de derivados do plasma que promovem a proliferação de fibroblastos, foi largamente pesquisada, desde a década de 40 (3,57,60,61).…”

Section: Técnicas Cirúrgicas De Reparo Neuralunclassified

Sutura química por polietilenoglicol na regeneração do nervo facial em ratos após neurotmese

Nascimento¹

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, cujo apoio senti em cada passo desse trabalho, às vezes com risos altos, às vezes com broncas, e às vezes silenciosamente, proporcionando-me as condições de seguir adiante. Agradeço sobretudo por servir de inspiração para mim e toda uma geração de otorrinos, transformando a especialidade no Brasil e fora.Ao Prof. Dr. Rubens Vuono de Brito Neto, meu mentor e inspiração durante a residência e mesmo depois, no ombro de quem já obtive amparo inúmeras vezes.Ao Dr. Robinson Koji Tsuji, exemplo de profissional ético e competente, por todo conhecimento compartilhado e amizade.À Dra. Raquel Salomone, por quem minha admiração e amizade nunca param de crescer, agradeço imensamente os insights, o estímulo, a disponibilidade e a amizade que nunca vacila, nem mede esforços.À Dra. Heloisa Juliana Zabeu Rossi Costa, por me ajudar em todas as etapas desse estudo, desde a ideia original até a escrita da tese. À Dra. Anna Carolina de Oliveira Fonseca, minha amiga e confidente, que tantas vezes me acolheu e me tranquilizou, por ser um grande estímulo na conclusão desse trabalho.Aos amigos que fiz na residência e preceptoria de otorrinolaringologia, LISTA DE GRÁFICOS BACKROUND:The gold standard treatment for traumatic transection of the FN continues to be end-to-end anastomosis using fibrin glue, which often yields unsatisfying results. OBJECTIVE: To test the outcome of a novel method of polyethylene glycol (PEG)-fusion on FN transection using electrophysiological and histophormometric parameters. METHODS: Wistar rats were divided into 4 groups. After FN transection, the control group was submitted to end-to-end anastomosis with microsutures. Group 2 was submitted to microsutures plus the PEG-fusion protocol. This protocol consisted in bathing nerve stumps with a calcium-free Krebs solution containing methylene blue (MB) before suturing. After suturing, the repaired nerve received a PEG solution followed by a calciumcontaining Krebs solution. Group 3 received microsutures plus the MB solution and group 4 received microsutures plus the PEG solution. Compound muscle action potentials (CMAPs) were recorded before the intervention and 3 and 6 weeks afterwards. Histomorphometric analysis was done at 6 weeks time. RESULTS:The PEG-fusion protocol yielded larger CMAP amplitude, smaller CMAP duration at 3 and 6 weeks and a larger axon count and axon diameter. Between the other groups, no significant difference was seen. CONCLUSION: PEG-fusion produces better FN recovery after transection, when considering electrophysiological and histomorphometric analysis and may be of use in clinical scenarios of FN cut-severance followed by immediate repair.

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The Comparison of Histological Results of Experimentally Created Facial Nerve Defects Repaired by 2 Different Anastomosis Techniques

Abstract: We conclude that N-butyl-2-cyanoacrylate is not an appropriate material for nerve anastomosis.

Cited by 9 publications

References 20 publications

Epineurial Window Is More Efficient in Attracting Axons than Simple Coaptation in a Sutureless (Cyanoacrylate-Bound) Model of End-to-Side Nerve Repair in the Rat Upper Limb: Functional and Morphometric Evidences and Review of the Literature

Epineurial Window Is More Efficient in Attracting Axons than Simple Coaptation in a Sutureless (Cyanoacrylate-Bound) Model of End-to-Side Nerve Repair in the Rat Upper Limb: Functional and Morphometric Evidences and Review of the Literature

Properties Live Axoplasm

Sutura química por polietilenoglicol na regeneração do nervo facial em ratos após neurotmese

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