Spector J G, Lee P, Derby A, Roufa D G
Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO 63110.
Laryngoscope. 1991 Oct;101(10):1109-23. doi: 10.1288/00005537-199110000-00014.
The early stages of rabbit peripheral facial nerve regeneration [N = 16], over a 10-mm transectional gap, were analyzed at 1, 3, and 5 weeks of buccal nerve entubation in silicone chambers prefilled with saline. Normal nerve pooled data were obtained in nine nerves. Chronologic morphologic and morphometic light and electron microscopic computer-captured data reveal that the regeneration process can be subdivided into four stages: 1. The establishment of an acellular intergap matrix; 2. the ingrowth of mesodermally derived cells (macrophages, fibroblasts, endothelial cells, etc.) to form an intergap scaffolding; 3. the ingrowth of ectodermally derived cells (neurons, Schwann's cells, etc.) to reconstitute the transected peripheral nerve; and 4. neural maturation by progressive axonal enlargement, myelination, and compartmentalization. The first two stages occur during the first week, the third stage during the third week, and the fourth stage from the fifth week onwards of neural entubation. Morphometic analyses indicate that total neuroregenerates increase in number from 303 +/- 286 to 2693 +/- 1334 (+/- values are standard deviations) and myelination of axons increases from 12% to 48% during the third to fifth week of entubation. The thickness of the myelin (g-ratio) increases from 0.89 +/- .01 to 0.74 +/- .06 (SD) during the same period of time. At the end of the fifth week of entubation, the midchambers contain, on the average, 1279 +/- 980 myelinated axons (30% of normal counts) and 483 (+/- 11.2%) axons cross the chambers to innervate the distal transected neural stump (12.5%). Specific target-organ (quadratus labii superioris muscle) activity can be recaptured with a smaller number (12.5%) of regenerating myelinated axons from the buccal division of the facial nerve during the fifth week of entubation.
在预先充满生理盐水的硅胶腔中进行颊神经插管1周、3周和5周后，对16只兔周围面神经在10毫米横断间隙上的早期再生阶段进行了分析。从九条正常神经中获取汇总数据。按时间顺序进行的形态学和形态计量学光镜及电镜计算机采集数据显示，再生过程可分为四个阶段：1. 无细胞间隙基质的形成；2. 中胚层来源细胞（巨噬细胞、成纤维细胞、内皮细胞等）向内生长以形成间隙支架；3. 外胚层来源细胞（神经元、施万细胞等）向内生长以重建横断的周围神经；4. 通过轴突逐渐增粗、髓鞘形成和分隔实现神经成熟。前两个阶段在第一周发生，第三阶段在第三周发生，第四阶段从神经插管的第五周开始。形态计量学分析表明，在插管的第三至第五周，总的神经再生数量从303±286增加到2693±1334（±值为标准差），轴突的髓鞘形成从12%增加到48%。同期，髓鞘厚度（g比值）从0.89±0.01增加到0.74±0.06（标准差）。在插管的第五周结束时，腔中部平均含有1279±980条有髓轴突（正常计数的30%），483条（±11.2%）轴突穿过腔室以支配远端横断的神经残端（12.5%）。在插管的第五周，从面神经颊支再生的数量较少（12.5%）的有髓轴突即可恢复特定靶器官（上唇方肌）的活动。
