Double muscle innervation using end-to-side neurorrhaphy in rats
Keywords:
Microsurgery, Sciatic nerve, Tibial nerve, Peroneal nerve, RatsAbstract
CONTEXT AND OBJECTIVE: One of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation. DESIGN AND SETTING: Experimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp. METHODS: One hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy. RESULTS: One hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred. CONCLUSION: These findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned.
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References
Millesi H. Peripheral nerve surgery today: turning point or continuous development? J Hand Surg Br. 1990;15(3):281-7.
Scaramella LF. Cross-face facial nerve anastomosis: historical notes. Ear Nose Throat J. 1996;75(6):343-52, 354.
Gillies H. Experiences with Fascia Lata Grafts in the Operative Treatment of Facial Paralysis: (Section of Otology and Section of Laryngology). Proc R Soc Med. 1934;27(10):1372-82.
Labbé D, Hamel M, Bénateau H. Myoplastie d’allongement du muscle temporal et greffe nerveuse transfaciale (VII-V). Note technique [Lengthening temporalis myoplasty and transfacial nerve graft (VII-V). Technical note]. Ann Chir Plast Esthet. 2003;48(1):31-5.
Labbé D, Huault M. Lengthening temporalis myoplasty and lip reanimation. Plast Reconstr Surg. 2000;105(4):1289-97; discussion 1298.
Viterbo F, Trindade JC, Hoshino K, Mazzoni Neto A. Latero-terminal neurorrhaphy without removal of the epineural sheath: experimental study in rats. Rev Paul Med. 1992;110(6):267-75.
Stipp-Brambilla EJ, Romão AM, Garbino JA, Salgado MH, Viterboz
F. Efeito da exposição cirúrgica de nervos e músculos no teste nerofisiológico em ratos [The effect of surgical exposure of nerves and muscles in neurophysiologic tests on rats]. Acta Fisiatr. 2010;17(3):109-11. Available from: http://www.actafisiatrica.org.br/v1/controle/secure/Arquivos/AnexosArtigos/8A146F1A3DA4700CBF03CDC55E2DAAE6/ACTA_1703_The%20effect%20of%20surgical%20exposure_v2.pdf. Accessed in 2012 (Mar 20).
Viterbo F, Trindade JC, Hoshino K, Mazzoni Neto A. End-to-side neurorrhaphy with removal of the epineural sheath: an experimental study in rats. Plast Reconstr Surg. 1994;94(7):1038-47.
Viterbo F, Trindade JC, Hoshino K, Mazzoni A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats. Br J Plast Surg. 1994;47(2):75-80.
Noah EM, Williams A, Jorgenson C, Skoulis TG, Terzis JK. End-to- side neurorrhaphy: a histologic and morphometric study of axonal sprouting into an end-to-side nerve grafts. J Reconstr Microsurg. 1997;13(2):99-106.
Shah MH, Kasabian AK, Karp NS, et al. Axonal regeneration through an autogenous nerve bypass: an experimental study in the rat. Ann Plast Surg. 1997;38(4):408-14; discussion 414-5.
Zhao JZ, Chen ZW, Chen TY. Nerve regeneration after terminolateral neurorrhaphy: experimental study in rats. J Reconstr Microsurg. 1997;13(1):31-7.
Lohman R, Bullock F, McNaughton T, Siemionow M. End-to-end vs. end-to-side neurorrhaphy. Journal of Reconstructive Microsurgery. 1997;13(2):135-6.
Yüksel F, Karacaoğlu E, Güler MM. Nerve regeneration through side-to-side neurorrhaphy sites in a rat model: a new concept in peripheral nerve surgery. Plast Reconstr Surg. 1999;104(7): 2092-9.
Kalliainen LK, Cederna PS, Kuzon WM Jr. Mechanical function of muscle reinnervated by end-to-side neurorrhaphy. Plast Reconstr Surg. 1999;103(7):1919-27.
Romão AM, Viterbo F, Stipp E, Garbino JA, Rodrigues JA. Eletroestimulação do músculo tibial cranial após esmagamento do nervo fibular comum: estudo neurofisiológico e morfométrico no rato [Muscle electro stimulation of the cranial tibial muscle after crushing of the common fibular nerve: neurophysiologic and morphometric study in rats. Rev Bras Ortop. 2007;42(3):41-6.
Cederna PS, Kalliainen LK, Urbanchek MG, Rovak JM, Kuzon WM Jr. “Donor” muscle structure and function after end-to-side neurorrhaphy. Plast Reconstr Surg. 2001;107(3):789-96.
Giovanoli P, Koller R, Meuli-Simmen C, et al. Functional and morphometric evaluation of end-to-side neurorrhaphy for muscle reinnervation. Plast Reconstr Surg. 2000;106(2):383-92.
Ozmen S, Latifoglu O, Ayhan S, et al. Impact of epineural excision of the distal recipient nerve in terminolateral neurorrhaphy. J Reconstr Microsurg. 2004;20(5):385-97.
Isaacs J, Allen D, Chen LE, Nunley J 2nd. Reverse end-to-side neurotization. J Reconstr Microsurg. 2005;21(1):43-8; discussion 49-50.
Isaacs JE, Cheatham S, Gagnon EB, Razavi A, McDowell CL. Reverse end-to-side neurotization in a regenerating nerve. J Reconstr Microsurg. 2008;24(7):489-96.
Brenner MJ, Dvali L, Hunter DA, Myckatyn TM, Mackinnon SE. Motor neuron regeneration through end-to-side repairs is a function of donor nerve axotomy. Plast Reconstr Surg. 2007;120(1):215-23.
Furukawa H, Saito A, Mol W, et al. Double innervation occurs in the facial mimetic muscles after facial-hypoglossal end-to-side neural repair: rat model for neural supercharge concept. J Plast Reconstr Aesthet Surg. 2008;61(3):257-64.
