机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing, Peoples R China;研究所北京市神经外科研究所首都医科大学附属天坛医院[2]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China;重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[3]INSERM, UMR 788, F-94276 Le Kremlin Bicetre, France;[4]Univ Paris 11, F-94276 Le Kremlin Bicetre, France;[5]INSERM, UMR 788, 80 Rue Gen Leclerc, F-94276 Le Kremlin Bicetre, France
Object. Hypoglossal-facial nerve neurorrhaphy is a widely used method for treating complete facial palsy. However, the classic surgical procedure using a "side"-to-end neurorrhaphy is not suitable for incomplete facial palsy (IFP), because sectioning of the facial nerve for neurorrhaphy compromises remnant axons and potential spontaneous reinnervation. For the treatment of persistent IFP, the authors investigated in rats a modified method using hypoglossal-facial nerve "side"-to-side neurorrhaphy. Methods. An IFP model was created by crushing the facial nerve and then ligating the injury site to limit axonal regeneration. After 9 weeks, rats with IFP were submitted to hypoglossal-facial nerve "side"-to-side neurorrhaphy: The gap between the 2 nerves was bridged with a predegenerated peroneal nerve graft, which was sutured to only one-half of the hypoglossal nerve and to the remnant facial nerve through a small window created by removing the epineurium, thus preserving regenerating facial axons. Results. Four months after repair surgery, double innervation of the target whisker pad by hypoglossal and facial motor neurons was supported by the recording of muscle action potentials and their retrograde labeling. Regenerated hypoglossal and facial motor neurons effectively participated in the reinnervation of the whisker pad, significantly improving facial symmetry without evident synkinesis, compared with rats that underwent IFP without hypoglossal-facial nerve neurorrhaphy. Conclusions. This study demonstrates that hypoglossal-facial nerve "side"-to-side neurorrhaphy with a predegenerated nerve graft can lead to rapid functional benefits for persistent IFP without compromising the remnants of facial axons, thus providing a proof-of-feasibility for further studies in humans.
基金:
Beijing Tiantan Hospital; Fondation de l'Avenir (Paris, France); Institut pour la Recherche sur la Moelle epiniere et l'Encephale (IRME) (Paris, France)
第一作者机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing, Peoples R China;
通讯作者:
通讯机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing, Peoples R China;[2]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China;[3]INSERM, UMR 788, F-94276 Le Kremlin Bicetre, France;[4]Univ Paris 11, F-94276 Le Kremlin Bicetre, France;[5]INSERM, UMR 788, 80 Rue Gen Leclerc, F-94276 Le Kremlin Bicetre, France
推荐引用方式(GB/T 7714):
Wan Hong,Zhang Liwei,Li Dezhi,et al.Hypoglossal-facial nerve "side"-to-side neurorrhaphy for persistent incomplete facial palsy[J].JOURNAL OF NEUROSURGERY.2014,120(1):263-272.doi:10.3171/2013.9.JNS13664.
APA:
Wan, Hong,Zhang, Liwei,Li, Dezhi,Hao, Shuyu,Feng, Jie...&Liu, Song.(2014).Hypoglossal-facial nerve "side"-to-side neurorrhaphy for persistent incomplete facial palsy.JOURNAL OF NEUROSURGERY,120,(1)
MLA:
Wan, Hong,et al."Hypoglossal-facial nerve "side"-to-side neurorrhaphy for persistent incomplete facial palsy".JOURNAL OF NEUROSURGERY 120..1(2014):263-272