Inada Yuji, Hosoi Hiroshi, Yamashita Akinori, Morimoto Shigeru, Tatsumi Hideaki, Notazawa Shunsuke, Kanemaru Shin-ichi, Nakamura Tatsuo
Department of Orthopedics, Inada Hospital, Nara, Japan.
Neurosurgery. 2007 Nov;61(5):E1105-7; discussion E1107. doi: 10.1227/01.neu.0000303210.45983.97.
After previous success in regenerating canine peripheral nerves over 80 mm gaps using a bioabsorbable nerve guide tube, we have extended this method to the treatment of patients experiencing various types of nerve injury. This report describes the treatment of two cases of motor nerve disorder.
The bioabsorbable nerve tube was a cylindrically woven polyglycolic acid (PGA) tube filled with collagen. A peripheral motor nerve defect (the frontalis branch of the facial nerve) was reconstructed using this PGA-collagen tube in two patients who experienced posttraumatic unilateral eyebrow ptosis for 3 months.
Five months after surgery, both patients regained their ability to voluntarily lift their eyebrows symmetrically. Electrophysiological examination at 5 months revealed recovery of compound muscle action potential and disappearance of distal latency on the affected side.
This is the first clinical report of motor nerve recovery achieved using the PGA-collagen nerve guide tube. The results suggest that use of a PGA-collagen tube is a promising option for the repair of motor nerve defects.
此前使用可生物吸收神经导管成功修复犬类80毫米以上间隙的周围神经后,我们将此方法扩展至治疗各类神经损伤的患者。本报告描述了两例运动神经障碍的治疗情况。
可生物吸收神经管是一种填充有胶原蛋白的圆柱形编织聚乙醇酸(PGA)管。在两名因外伤导致单侧眉毛下垂3个月的患者中,使用这种PGA-胶原蛋白管重建周围运动神经缺损(面神经额支)。
术后5个月,两名患者均恢复了对称自主抬眉的能力。术后5个月的电生理检查显示,患侧复合肌肉动作电位恢复,远端潜伏期消失。
这是使用PGA-胶原蛋白神经导管实现运动神经恢复的首份临床报告。结果表明,使用PGA-胶原蛋白管是修复运动神经缺损的一个有前景的选择。