The new heterologous fibrin sealant in combination with low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve

Abstract

This study aimed to evaluate the effects of low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve with two surgical techniques: end-to-end epineural suture and coaptation with heterologous fibrin sealant. Forty-two male Wistar rats were randomly divided into five groups: control group (CG) in which the buccal branch of the facial nerve was collected without injury; (2) experimental group with suture (EGS) and experimental group with fibrin (EGF): The buccal branch of the facial nerve was transected on both sides of the face. End-to-end suture was performed on the right side and fibrin sealant on the left side; (3) Experimental group with suture and laser (EGSL) and experimental group with fibrin and laser (EGFL). All animals underwent the same surgical procedures in the EGS and EGF groups, in combination with the application of LLLT (wavelength of 830 nm, 30 mW optical power output of potency, and energy density of 6 J/cm(2)). The animals of the five groups were euthanized at 5 weeks post-surgery and 10 weeks post-surgery. Axonal sprouting was observed in the distal stump of the facial nerve in all experimental groups. The observed morphology was similar to the fibers of the control group, with a predominance of myelinated fibers. In the final period of the experiment, the EGSL presented the closest results to the CG, in all variables measured, except in the axon area. Both surgical techniques analyzed were effective in the treatment of peripheral nerve injuries, where the use of fibrin sealant allowed the manipulation of the nerve stumps without trauma. LLLT exhibited satisfactory results on facial nerve regeneration, being therefore a useful technique to stimulate axonal regeneration process.

Photobiomodulation Therapy (PBMT) in Peripheral Nerve Regeneration: A Systematic Review

“…With the evolution of the technology in the health field and the evolution of the adjunct methods for rehabilitation and functional restoration of injured nerves [3,6,7,8,9], the PBMT has shown a wide range of benefits with clinical relevance. Thus, the aim of this research was to carry out a review of the scientific papers published in the last 10 years in order to verify the relation of PBMT in the regeneration of injured peripheral nerves.…”

“…Among the effects of PBMT on nerve injury, it was verified that the laser minimized the side effects of bupivacaine on the nerve and on the muscle [29], potentiated the process of nerve regeneration observed by morpho-quantitative analysis of the axons and of the nerve fibers [2,3,19,30,31,32,33,34,35], in addition to assisting muscular reinnervation [36]. …”

“…Its effects are related to tissue biostimulation, presenting therapeutic responses from photoelectric, photoenergetic, and photochemical reactions [1]. Scientific research has shown the application of PBMT in bone tissue and peripheral nerves with good results whether or not it is associated with other supporting methods in tissue repair [2,3,4,5,6,7]. …”

“…Its beneficial effects are independent of the repair technique, neurorrhaphy techniques, and the use of fibrin sealants [3,6,7,21]. …”

Low-Level Laser Therapy (LLLT) Improves the Repair Process of Peripheral Nerve Injuries: A Mini Review

“…Fibrin sealant derived from snake venom (Crotalus durissus terrificus) has been highlighted in the international literature [10][11][12][13]. Produced by the research group of the Center for the Study of Venoms and Venomous Animals (CEVAP, UNESP/Botucatu-SP, Brazil), it presents three individual solutions that must be homogenized before application: fibrinogen originated from buffalo blood; calcium chloride and a thrombin-like fraction.…”