Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Hokkaido at Sapporo (UHS), Kita-15 Nishi-7, Kita-Ku, Sapporo, Hokkaido 060-8638, Japan.
J Plast Reconstr Aesthet Surg. 2012 Jun;65(6):763-70. doi: 10.1016/j.bjps.2011.12.009. Epub 2012 Feb 1.
The use of an interpositional nerve graft (IPNG) between the facial and hypoglossal nerves for incomplete facial palsy has recently been reported. However, its mechanism has not been elucidated. We established a rat model of IPNG to study incomplete facial palsy and confirmed the direction of innervation through the grafted nerve with or without facial nerve injury.
Twenty rats were divided into five groups (n = 4): a control group (group A), an incomplete facial palsy group (group B), an IPNG-treated group (group C), an incomplete facial palsy group treated with IPNG (group D) and an incomplete hypoglossal nerve palsy group treated with IPNG (group E). After surgery, mimetic muscle movement was evaluated using an original scoring system. Twelve weeks after surgery, the mimetic muscles of the tongue were injected with Fast Blue and DiI. Retrograde-labelled neurons were counted through the facial and hypoglossal nuclei, and mimetic muscle specimens stained with Masson's trichrome were examined.
Fast Blue-labelled neurons were noted in the hypoglossal nucleus in groups C and D, and DiI-labelled neurons within the facial nucleus were noted in groups C and E. The group D facial palsy score statistically exceeded the group B score.
The results revealed that axonal regeneration through IPNG is bi-directional and is preferentially directed towards the injured side. Innervation from the hypoglossal nerve to mimetic muscles through IPNG prevents muscle atrophy and helps counter facial palsy.
在面神经和舌下神经之间使用神经移植（IPNG）治疗不完全性面瘫最近已有报道。然而，其机制尚未阐明。我们建立了大鼠 IPNG 模型来研究不完全性面瘫，并通过有无面神经损伤的移植神经确认了神经支配的方向。
20 只大鼠分为 5 组（n=4）：对照组（A 组）、不完全性面瘫组（B 组）、IPNG 治疗组（C 组）、面神经损伤后行 IPNG 治疗组（D 组）和不完全性舌下神经瘫痪后行 IPNG 治疗组（E 组）。手术后，使用原始评分系统评估拟态肌运动。术后 12 周，用 Fast Blue 和 DiI 标记舌的拟态肌。通过面神经核和舌下神经核对逆行标记神经元进行计数，并检查用 Masson 三色染色的拟态肌标本。
C 组和 D 组的舌下神经核中可见 Fast Blue 标记的神经元，C 组和 E 组的面神经核内可见 DiI 标记的神经元。D 组面瘫评分明显高于 B 组。
结果表明，通过 IPNG 的轴突再生是双向的，并且优先朝向损伤侧。通过 IPNG 从舌下神经向拟态肌的神经支配可防止肌肉萎缩，有助于对抗面瘫。
