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Effectively Axonal-supercharged Interpositional Jump-Graft with an Artificial Nerve Conduit for Rat Facial Nerve Paralysis.

Niimi Y, Matsumine H, Takeuchi Y, Sasaki R, Watanabe Y, Yamato M, Miyata M, Sakurai H - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve.Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve.In the autograft and silicone tube groups, the regeneration of myelinated axons was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo-shi, Chiba, Japan; Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Physiology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; and Department of Oral and Maxillofacial Surgery, Global Center of Excellence (COE) Program, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

ABSTRACT

Background: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve. However, for using the technique, an autologous nerve, which should contain the great auricular and sural nerves, must be obtained. Depending on the donor site, unavoidable issues such as nerve disorders and postoperative scarring may appear. To reduce the issues, in this study, the authors developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit and investigated the efficacy of an IPJG with an artificial nerve conduit in a rat facial nerve paresis model.

Methods: A ligature clip was used to crush the facial nerve trunk, thereby creating a partial facial nerve paresis model. An artificial nerve conduit was then prepared with a 10-mm-long silicone tube containing 10 μL type I collagen and used to create an IPJG between the facial nerve trunk and the hypoglossal nerve (the silicone tube group). Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve.

Results: Retrograde tracer test confirmed a double innervation by the facial and hypoglossal nerve nuclei. In the autograft and silicone tube groups, the regeneration of myelinated axons was observed.

Conclusion: In this study, the authors successfully developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit, and revealed that an IPJG in the conduit was effective in the rat facial nerve paresis model.

No MeSH data available.


Related in: MedlinePlus

Incision site in rat and nerve transplantation procedures. A, An S-shaped incision was made from behind the left ear to the lower margin of the mandible. B, The facial nerve trunk (F), the hypoglossal nerve (H), and the great auricular nerve (G) were identified. Large blue line was a strip of rubber for visualizing these nerves. C, IPJG prepared with an autologous nerve. After a left partial facial nerve paresis model with a ligature clip placed on the facial nerve trunk was prepared, IPJG was made by end-to-side neurorrhaphy with the ipsilateral great auricular nerve (G) between the hypoglossal nerve and the facial nerve trunk (the autograft group). D, IPJG would be regenerated in an artificial nerve conduit. After a left partial facial nerve paresis model with a ligature clip was prepared, an IPJG was made by end-to-side neurorrhaphy with a silicone tube containing 10 μL type I collagen solution (0.3 wt/vol %) between the hypoglossal nerve and the facial nerve trunk (the silicone tube group).
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Figure 1: Incision site in rat and nerve transplantation procedures. A, An S-shaped incision was made from behind the left ear to the lower margin of the mandible. B, The facial nerve trunk (F), the hypoglossal nerve (H), and the great auricular nerve (G) were identified. Large blue line was a strip of rubber for visualizing these nerves. C, IPJG prepared with an autologous nerve. After a left partial facial nerve paresis model with a ligature clip placed on the facial nerve trunk was prepared, IPJG was made by end-to-side neurorrhaphy with the ipsilateral great auricular nerve (G) between the hypoglossal nerve and the facial nerve trunk (the autograft group). D, IPJG would be regenerated in an artificial nerve conduit. After a left partial facial nerve paresis model with a ligature clip was prepared, an IPJG was made by end-to-side neurorrhaphy with a silicone tube containing 10 μL type I collagen solution (0.3 wt/vol %) between the hypoglossal nerve and the facial nerve trunk (the silicone tube group).

Mentions: Lewis rats (8 weeks old, n = 14) (CLEA Japan, Tokyo, Japan) were anesthetized with 4% isoflurane using a nasal mask connected to an Univentor 400 Anesthesia Unit (Univentor, Zejtun, Malta) and placed in a right lateral decubitus position.10 An S-shaped incision was made from behind the left ear to the lower margin of the mandible while the animals were under inhalational anesthesia (Fig. 1A). The great auricular nerve was identified on the sternocleidomastoid muscle after subcutaneous tissue dissection approximately 10 mm ventral to the posterior auricular surface. In this way, the dissection was advanced to the attachment of the sternocleidomastoid muscle, and the facial nerve trunk was identified. Thereafter, the external jugular vein was ligatured and transected, and the digastricus was exposed after subcutaneous tissue dissection. The posterior surface was dissected from the caudal side of the digastricus, and the hypoglossal nerve was identified (Fig. 1B).


Effectively Axonal-supercharged Interpositional Jump-Graft with an Artificial Nerve Conduit for Rat Facial Nerve Paralysis.

Niimi Y, Matsumine H, Takeuchi Y, Sasaki R, Watanabe Y, Yamato M, Miyata M, Sakurai H - Plast Reconstr Surg Glob Open (2015)

Incision site in rat and nerve transplantation procedures. A, An S-shaped incision was made from behind the left ear to the lower margin of the mandible. B, The facial nerve trunk (F), the hypoglossal nerve (H), and the great auricular nerve (G) were identified. Large blue line was a strip of rubber for visualizing these nerves. C, IPJG prepared with an autologous nerve. After a left partial facial nerve paresis model with a ligature clip placed on the facial nerve trunk was prepared, IPJG was made by end-to-side neurorrhaphy with the ipsilateral great auricular nerve (G) between the hypoglossal nerve and the facial nerve trunk (the autograft group). D, IPJG would be regenerated in an artificial nerve conduit. After a left partial facial nerve paresis model with a ligature clip was prepared, an IPJG was made by end-to-side neurorrhaphy with a silicone tube containing 10 μL type I collagen solution (0.3 wt/vol %) between the hypoglossal nerve and the facial nerve trunk (the silicone tube group).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494486&req=5

Figure 1: Incision site in rat and nerve transplantation procedures. A, An S-shaped incision was made from behind the left ear to the lower margin of the mandible. B, The facial nerve trunk (F), the hypoglossal nerve (H), and the great auricular nerve (G) were identified. Large blue line was a strip of rubber for visualizing these nerves. C, IPJG prepared with an autologous nerve. After a left partial facial nerve paresis model with a ligature clip placed on the facial nerve trunk was prepared, IPJG was made by end-to-side neurorrhaphy with the ipsilateral great auricular nerve (G) between the hypoglossal nerve and the facial nerve trunk (the autograft group). D, IPJG would be regenerated in an artificial nerve conduit. After a left partial facial nerve paresis model with a ligature clip was prepared, an IPJG was made by end-to-side neurorrhaphy with a silicone tube containing 10 μL type I collagen solution (0.3 wt/vol %) between the hypoglossal nerve and the facial nerve trunk (the silicone tube group).
Mentions: Lewis rats (8 weeks old, n = 14) (CLEA Japan, Tokyo, Japan) were anesthetized with 4% isoflurane using a nasal mask connected to an Univentor 400 Anesthesia Unit (Univentor, Zejtun, Malta) and placed in a right lateral decubitus position.10 An S-shaped incision was made from behind the left ear to the lower margin of the mandible while the animals were under inhalational anesthesia (Fig. 1A). The great auricular nerve was identified on the sternocleidomastoid muscle after subcutaneous tissue dissection approximately 10 mm ventral to the posterior auricular surface. In this way, the dissection was advanced to the attachment of the sternocleidomastoid muscle, and the facial nerve trunk was identified. Thereafter, the external jugular vein was ligatured and transected, and the digastricus was exposed after subcutaneous tissue dissection. The posterior surface was dissected from the caudal side of the digastricus, and the hypoglossal nerve was identified (Fig. 1B).

Bottom Line: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve.Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve.In the autograft and silicone tube groups, the regeneration of myelinated axons was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo-shi, Chiba, Japan; Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Physiology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; and Department of Oral and Maxillofacial Surgery, Global Center of Excellence (COE) Program, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

ABSTRACT

Background: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve. However, for using the technique, an autologous nerve, which should contain the great auricular and sural nerves, must be obtained. Depending on the donor site, unavoidable issues such as nerve disorders and postoperative scarring may appear. To reduce the issues, in this study, the authors developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit and investigated the efficacy of an IPJG with an artificial nerve conduit in a rat facial nerve paresis model.

Methods: A ligature clip was used to crush the facial nerve trunk, thereby creating a partial facial nerve paresis model. An artificial nerve conduit was then prepared with a 10-mm-long silicone tube containing 10 μL type I collagen and used to create an IPJG between the facial nerve trunk and the hypoglossal nerve (the silicone tube group). Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve.

Results: Retrograde tracer test confirmed a double innervation by the facial and hypoglossal nerve nuclei. In the autograft and silicone tube groups, the regeneration of myelinated axons was observed.

Conclusion: In this study, the authors successfully developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit, and revealed that an IPJG in the conduit was effective in the rat facial nerve paresis model.

No MeSH data available.


Related in: MedlinePlus