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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

CMAP analysis. For recording CMAP, a stainless steel microelectrode (9–12 MΩ at 1 kHz) (Uesmgcselnnm-type) (FHC, Bowdoin, Maine) was inserted into the vibrissal muscles between the middle vibrissal rows C and D. A reference electrode (TN204-089B) (Unique Medical, Tokyo, Japan) was placed in the caudal position of the skull. For stimulating the regenerated facial nerve, a tandem hook-shaped stimulation electrode (IMC-220224) (InterMedical, Aichi, Japan) was connected to the exfoliated nerve of the buccal branch of facial nerve in the autograft (n = 3) and silicone tube groups (n = 4), and stimulation pulses at a supramaximal level of 2 mA (100 μs monopolar pulses) were delivered at 0.2 Hz via an isolator (SS-202J) (Nihon Kohden, Tokyo, Japan). Recorded signals were processed with a multichannel amplifier (MEG-6100) (Nihon Kohden) at 15–10,000 Hz and digitized at 40 kHz using a PowerLab4/30 and LabChart7 system (ADInstruments, Dunedin, New Zealand). Data were analyzed in an off-line manner with Igor Pro software (Wavemetrics, Lake Oswego, Oreg.). The upward trace of CMAP gave a negative deflection (depolarization), and 10 consecutive traces were averaged. CMAP traces recorded from a whisker pad after supramaximal stimulation IPJG with autograft (A) and in silicone tube (B). Although amplitude (C) values were significantly larger in the autograft group (4.19 ± 1.02 mV) (n = 3) than those in the silicone tube group (1.76 ± 1.43 mV) (n = 4), latency (E) values were significantly lower in the autograft graft group (2.93 ± 0.85 ms) (n = 3) than those in the silicone tube group (5.56 ± 2.65 ms) (n = 4). D, No significant difference in duration was observed (0.89 ± 0.63 ms vs 1.08 ± 0.30 ms). CMAP amplitude, duration, and latency were compared by unpaired t test. *P < 0.05. **P < 0.01. ns indicates not significant.
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Figure 6: CMAP analysis. For recording CMAP, a stainless steel microelectrode (9–12 MΩ at 1 kHz) (Uesmgcselnnm-type) (FHC, Bowdoin, Maine) was inserted into the vibrissal muscles between the middle vibrissal rows C and D. A reference electrode (TN204-089B) (Unique Medical, Tokyo, Japan) was placed in the caudal position of the skull. For stimulating the regenerated facial nerve, a tandem hook-shaped stimulation electrode (IMC-220224) (InterMedical, Aichi, Japan) was connected to the exfoliated nerve of the buccal branch of facial nerve in the autograft (n = 3) and silicone tube groups (n = 4), and stimulation pulses at a supramaximal level of 2 mA (100 μs monopolar pulses) were delivered at 0.2 Hz via an isolator (SS-202J) (Nihon Kohden, Tokyo, Japan). Recorded signals were processed with a multichannel amplifier (MEG-6100) (Nihon Kohden) at 15–10,000 Hz and digitized at 40 kHz using a PowerLab4/30 and LabChart7 system (ADInstruments, Dunedin, New Zealand). Data were analyzed in an off-line manner with Igor Pro software (Wavemetrics, Lake Oswego, Oreg.). The upward trace of CMAP gave a negative deflection (depolarization), and 10 consecutive traces were averaged. CMAP traces recorded from a whisker pad after supramaximal stimulation IPJG with autograft (A) and in silicone tube (B). Although amplitude (C) values were significantly larger in the autograft group (4.19 ± 1.02 mV) (n = 3) than those in the silicone tube group (1.76 ± 1.43 mV) (n = 4), latency (E) values were significantly lower in the autograft graft group (2.93 ± 0.85 ms) (n = 3) than those in the silicone tube group (5.56 ± 2.65 ms) (n = 4). D, No significant difference in duration was observed (0.89 ± 0.63 ms vs 1.08 ± 0.30 ms). CMAP amplitude, duration, and latency were compared by unpaired t test. *P < 0.05. **P < 0.01. ns indicates not significant.

Mentions: In CMAP physiological tests, the contraction signal of facial muscles for expression supplied by the buccal branch of the facial nerve was observed after the electrical stimulation of this branch in both groups (Figs. 6A, B). Although no difference was observed in CMAP duration between the autograft and silicone tube groups (0.89 ± 0.63 ms and 1.08 ± 0.30 ms) (Fig. 6D), the amplitude values were significantly higher (P < 0.01; Fig. 6C), and the latency values were significantly lower (P < 0.05; Fig. 6E) in the autograft graft group (4.19 ± 1.02 mV and 2.93 ± 0.85 ms) (n = 3) than in the silicone tube group (1.77 ± 1.43 mV and 5.56 ± 2.65 ms) (n = 4). These results indicated that rat facial muscles contracted by the stimuli of regenerated nerve in the silicone tube group.


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)

CMAP analysis. For recording CMAP, a stainless steel microelectrode (9–12 MΩ at 1 kHz) (Uesmgcselnnm-type) (FHC, Bowdoin, Maine) was inserted into the vibrissal muscles between the middle vibrissal rows C and D. A reference electrode (TN204-089B) (Unique Medical, Tokyo, Japan) was placed in the caudal position of the skull. For stimulating the regenerated facial nerve, a tandem hook-shaped stimulation electrode (IMC-220224) (InterMedical, Aichi, Japan) was connected to the exfoliated nerve of the buccal branch of facial nerve in the autograft (n = 3) and silicone tube groups (n = 4), and stimulation pulses at a supramaximal level of 2 mA (100 μs monopolar pulses) were delivered at 0.2 Hz via an isolator (SS-202J) (Nihon Kohden, Tokyo, Japan). Recorded signals were processed with a multichannel amplifier (MEG-6100) (Nihon Kohden) at 15–10,000 Hz and digitized at 40 kHz using a PowerLab4/30 and LabChart7 system (ADInstruments, Dunedin, New Zealand). Data were analyzed in an off-line manner with Igor Pro software (Wavemetrics, Lake Oswego, Oreg.). The upward trace of CMAP gave a negative deflection (depolarization), and 10 consecutive traces were averaged. CMAP traces recorded from a whisker pad after supramaximal stimulation IPJG with autograft (A) and in silicone tube (B). Although amplitude (C) values were significantly larger in the autograft group (4.19 ± 1.02 mV) (n = 3) than those in the silicone tube group (1.76 ± 1.43 mV) (n = 4), latency (E) values were significantly lower in the autograft graft group (2.93 ± 0.85 ms) (n = 3) than those in the silicone tube group (5.56 ± 2.65 ms) (n = 4). D, No significant difference in duration was observed (0.89 ± 0.63 ms vs 1.08 ± 0.30 ms). CMAP amplitude, duration, and latency were compared by unpaired t test. *P < 0.05. **P < 0.01. ns indicates not significant.
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Figure 6: CMAP analysis. For recording CMAP, a stainless steel microelectrode (9–12 MΩ at 1 kHz) (Uesmgcselnnm-type) (FHC, Bowdoin, Maine) was inserted into the vibrissal muscles between the middle vibrissal rows C and D. A reference electrode (TN204-089B) (Unique Medical, Tokyo, Japan) was placed in the caudal position of the skull. For stimulating the regenerated facial nerve, a tandem hook-shaped stimulation electrode (IMC-220224) (InterMedical, Aichi, Japan) was connected to the exfoliated nerve of the buccal branch of facial nerve in the autograft (n = 3) and silicone tube groups (n = 4), and stimulation pulses at a supramaximal level of 2 mA (100 μs monopolar pulses) were delivered at 0.2 Hz via an isolator (SS-202J) (Nihon Kohden, Tokyo, Japan). Recorded signals were processed with a multichannel amplifier (MEG-6100) (Nihon Kohden) at 15–10,000 Hz and digitized at 40 kHz using a PowerLab4/30 and LabChart7 system (ADInstruments, Dunedin, New Zealand). Data were analyzed in an off-line manner with Igor Pro software (Wavemetrics, Lake Oswego, Oreg.). The upward trace of CMAP gave a negative deflection (depolarization), and 10 consecutive traces were averaged. CMAP traces recorded from a whisker pad after supramaximal stimulation IPJG with autograft (A) and in silicone tube (B). Although amplitude (C) values were significantly larger in the autograft group (4.19 ± 1.02 mV) (n = 3) than those in the silicone tube group (1.76 ± 1.43 mV) (n = 4), latency (E) values were significantly lower in the autograft graft group (2.93 ± 0.85 ms) (n = 3) than those in the silicone tube group (5.56 ± 2.65 ms) (n = 4). D, No significant difference in duration was observed (0.89 ± 0.63 ms vs 1.08 ± 0.30 ms). CMAP amplitude, duration, and latency were compared by unpaired t test. *P < 0.05. **P < 0.01. ns indicates not significant.
Mentions: In CMAP physiological tests, the contraction signal of facial muscles for expression supplied by the buccal branch of the facial nerve was observed after the electrical stimulation of this branch in both groups (Figs. 6A, B). Although no difference was observed in CMAP duration between the autograft and silicone tube groups (0.89 ± 0.63 ms and 1.08 ± 0.30 ms) (Fig. 6D), the amplitude values were significantly higher (P < 0.01; Fig. 6C), and the latency values were significantly lower (P < 0.05; Fig. 6E) in the autograft graft group (4.19 ± 1.02 mV and 2.93 ± 0.85 ms) (n = 3) than in the silicone tube group (1.77 ± 1.43 mV and 5.56 ± 2.65 ms) (n = 4). These results indicated that rat facial muscles contracted by the stimuli of regenerated nerve in the silicone tube group.

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