Summary
Prevention of the atrophy of denervated muscles is essential for a good outcome in
facial contouring and oral reconstruction. In this study, we compared the effectiveness
of end-to-end and end-to-side neurorrhaphy of the motor nerve, and end-to-end neurorrhaphy
of the sensory nerve, all of which are frequently used in such reconstruction for
the prevention of muscle atrophy.
Wistar rats were divided into four groups: group 1, motor nerve division of semi-membranosus
without repair; group 2, motor nerve division and end-to-end coaptation to the saphenous
nerve; group 3, motor nerve division and end-to-side coaptation to the sciatic nerve;
and group 4, motor nerve division and end-to-end repair.
Measurement of semi-membranosus volume, histological evaluation and staining of neuromuscular
junctions that were carried out 3 months postoperatively revealed that muscle volume
preservation was larger in groups 3 and 4 than in the other two groups (p<0.05), but slightly superior in group 4 (p<0.05). There was no statistical difference between groups 2 and 1; histologically,
muscle architecture was better preserved in group 2 than in group 1; reactivation
of the neuromuscular junctions was observed in all except group 1.
End-to-side repair of motor nerves is one of the better options for the preservation
of muscle volume when end-to-end nerve repair is not indicated. Sensory protection
may also provide some advantages in the preservation of muscle volume.
Keywords
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References
- Analysis of the relations between the shape of the reconstructed tongue and postoperative functions after subtotal or total glossectomy.The Laryngoscope. 2003; 113: 905-909
- Correlation of neotongue volume changes with functional outcomes after long-term follow-up of total glossectomy.J Craniofacial Surg. 2010; 21: 111-116
- Preservation of denervated muscle by sensory protection in rats.J Reconstr Microsurg. 1997; 13: 337-343
- Mechanical function of muscle reinnervated by end-to-side neurorrhaphy.Plast Reconstr Surg. 1999; 103: 1919-1927
- Muscle flap mass preservation with end-to-side neurorrhaphy: an experimental study.J Reconstr Microsurg. 2004; 20: 483-488
- Contribution of the distal nerve sheath to nerve and muscle preservation following denervation and sensory protection.J Reconstr Microsurg. 2005; 21 (discussion 1–4): 57-70
- Muscle flap mass preservation by sensory reinnervation with end-to-side neurorrhaphy: an experimental study in rats.J Reconstr Microsurg. 2008; 24: 479-487
- Comparison of muscle mass preservation in denervated muscle and transplanted muscle flaps after motor and sensory reinnervation and neurotization.Plast Reconstr Surg. 1997; 99: 803-814
- Improved functional recovery of denervated skeletal muscle after temporary sensory nerve innervation.Neuroscience. 2001; 103: 503-510
- “Donor” muscle structure and function after end-to-side neurorrhaphy.Plast Reconstr Surg. 2001; 107: 789-796
- The end-to-side peripheral nerve repair. Functional and morphometric study using the peroneal nerve of rats.J Neurosci Methods. 2004; 136: 45-53
- End-to-side nerve repair: review of the literature.Restor Neurol Neurosci. 2007; 25: 45-63
- Reinnervation after end-to-side nerve coaptation in a rat model.Am J Orthop (Belle Mead NJ). 2001; 30 (discussion 7): 400-406
- Nerve regeneration after terminolateral neurorrhaphy: experimental study in rats.J Reconstr Microsurg. 1997; 13: 31-37
- Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats.Br J Plast Surg. 1994; 47: 75-80
- End-to-side neurorrhaphy with removal of the epineurial sheath: an experimental study in rats.Plast Reconstr Surg. 1994; 94: 1038-1047
- Nerve injury and repair. 2nd ed. Elsevier, 2004
- Collateral sprouting occurs following end-to-side neurorrhaphy.Plast Reconstr Surg. 2004; 114: 129-137
- NGF. BDNF, NT-3, and GDNF mRNA expression in rat skeletal muscle following denervation and sensory protection.J Neurotrauma. 2004; 21: 1468-1478
- Neurotrophic factors and their receptors in axonal regeneration and functional recovery after peripheral nerve injury.Mol Neurobiol. 2003; 27: 277-324
- Is axonal sprouting able to traverse the conjunctival layers of the peripheral nerve? A behavioral, motor, and sensory study of end-to-side nerve anastomosis.J Reconstr Microsurg. 1996; 12: 559-563
Article info
Publication history
Published online: February 27, 2012
Accepted:
January 26,
2012
Received:
March 15,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
