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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

Transmission electron microscope observations of IPJGs at postoperative weeks 7 (A and B) and 13 (C and D). The left and right columns show IPJGs with autograft and in a silicone tube conduit, respectively. The upper and lower rows show the observations at postoperative weeks 7 and 13, respectively. B, Although axonal regeneration was observed in the regenerating nerve in the silicone tube group at week 7, no regeneration of the myelin sheath was observed. D, A comparatively thick and substantial annular myelin sheath was observed in the silicone tube group at week 13. A and C, Regeneration of mature myelin sheath was observed in the autograft group at postoperative week 7 and 13.
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Figure 4: Transmission electron microscope observations of IPJGs at postoperative weeks 7 (A and B) and 13 (C and D). The left and right columns show IPJGs with autograft and in a silicone tube conduit, respectively. The upper and lower rows show the observations at postoperative weeks 7 and 13, respectively. B, Although axonal regeneration was observed in the regenerating nerve in the silicone tube group at week 7, no regeneration of the myelin sheath was observed. D, A comparatively thick and substantial annular myelin sheath was observed in the silicone tube group at week 13. A and C, Regeneration of mature myelin sheath was observed in the autograft group at postoperative week 7 and 13.

Mentions: Although axonal regeneration was observed with transmission electron microscope in regenerated nerve in the silicone tube group at postoperative week 7 (Fig. 4B), no myelin sheath regeneration was observed. A comparatively thin, however, annular myelin sheath was observed at postoperative week 13 in the group (Fig. 4D). In the autograft group, the regeneration of a thick and substantial annular myelin sheath was observed from postoperative week 7 (Fig. 4A), whereas a thickened, more mature myelin sheath was observed at postoperative week 13 (Fig. 4B). The mean number of myelinated fibers was significantly higher in the autograft group (1980 ± 287) than in the silicone tube group (211 ± 89.2) (P < 0.001; Fig. 5A). The mean fiber diameter, axon diameter, and myelin thickness were significantly higher in the autograft group (7.09 ± 2.4 μm, 5.59 ± 2.12 μm, and 0.75 ± 0.2 μm, respectively) than in the silicone tube group (5.07 ± 1.36 μm, 4.39 ± 1.3 μm, and 0.34 ± 0.08 μm, respectively) (P < 0.001; Fig. 5). The g ratio of the autograft group (0.78 ± 0.05) was significantly lower than that of the silicone tube group (0.86 ± 0.04) (P < 0.0001; Fig. 5).


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)

Transmission electron microscope observations of IPJGs at postoperative weeks 7 (A and B) and 13 (C and D). The left and right columns show IPJGs with autograft and in a silicone tube conduit, respectively. The upper and lower rows show the observations at postoperative weeks 7 and 13, respectively. B, Although axonal regeneration was observed in the regenerating nerve in the silicone tube group at week 7, no regeneration of the myelin sheath was observed. D, A comparatively thick and substantial annular myelin sheath was observed in the silicone tube group at week 13. A and C, Regeneration of mature myelin sheath was observed in the autograft group at postoperative week 7 and 13.
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Related In: Results  -  Collection

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Figure 4: Transmission electron microscope observations of IPJGs at postoperative weeks 7 (A and B) and 13 (C and D). The left and right columns show IPJGs with autograft and in a silicone tube conduit, respectively. The upper and lower rows show the observations at postoperative weeks 7 and 13, respectively. B, Although axonal regeneration was observed in the regenerating nerve in the silicone tube group at week 7, no regeneration of the myelin sheath was observed. D, A comparatively thick and substantial annular myelin sheath was observed in the silicone tube group at week 13. A and C, Regeneration of mature myelin sheath was observed in the autograft group at postoperative week 7 and 13.
Mentions: Although axonal regeneration was observed with transmission electron microscope in regenerated nerve in the silicone tube group at postoperative week 7 (Fig. 4B), no myelin sheath regeneration was observed. A comparatively thin, however, annular myelin sheath was observed at postoperative week 13 in the group (Fig. 4D). In the autograft group, the regeneration of a thick and substantial annular myelin sheath was observed from postoperative week 7 (Fig. 4A), whereas a thickened, more mature myelin sheath was observed at postoperative week 13 (Fig. 4B). The mean number of myelinated fibers was significantly higher in the autograft group (1980 ± 287) than in the silicone tube group (211 ± 89.2) (P < 0.001; Fig. 5A). The mean fiber diameter, axon diameter, and myelin thickness were significantly higher in the autograft group (7.09 ± 2.4 μm, 5.59 ± 2.12 μm, and 0.75 ± 0.2 μm, respectively) than in the silicone tube group (5.07 ± 1.36 μm, 4.39 ± 1.3 μm, and 0.34 ± 0.08 μm, respectively) (P < 0.001; Fig. 5). The g ratio of the autograft group (0.78 ± 0.05) was significantly lower than that of the silicone tube group (0.86 ± 0.04) (P < 0.0001; Fig. 5).

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