Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts 02114, USA.
Laryngoscope. 2013 Jul;123(7):1618-21. doi: 10.1002/lary.23885. Epub 2012 Nov 27.
OBJECTIVES/HYPOTHESIS: Repair of the transected facial nerve has traditionally been accomplished with microsurgical neurorrhaphy; however, fibrin adhesive coaptation (FAC) of peripheral nerves has become increasingly popular over the past decade. We compared functional recovery following suture neurorrhaphy to FAC in a rodent facial nerve model.
Prospective, randomized animal study.
Sixteen rats underwent transection and repair of the facial nerve proximal to the pes anserinus. Eight animals underwent epineurial suture (ES) neurorrhaphy, and eight underwent repair with fibrin adhesive (FA). Surgical times were documented for all procedures. Whisking function was analyzed on a weekly basis for both groups across 15 weeks of recovery.
Rats experienced whisking recovery consistent in time course and degree with prior studies of rodent facial nerve transection and repair. There were no significant differences in whisking amplitude, velocity, or acceleration between suture and FA groups. However, the neurorrhaphy time with FA was 70% shorter than for ES (P < 0.05).
Although we found no difference in whisking recovery between suture and FA repair of the main trunk of the rat facial nerve, the significantly shorter operative time for FA repair makes this technique an attractive option. The relative advantages of both techniques are discussed.
目的/假设:传统上,面神经的横断修复采用显微神经吻合术;然而,在过去十年中,纤维蛋白粘合剂(FAC)吻合周围神经越来越受欢迎。我们在啮齿动物面神经模型中比较了缝合神经吻合术和 FAC 后的功能恢复情况。
前瞻性、随机动物研究。
16 只大鼠在鹅足前接受面神经近端横断和修复。8 只动物行外膜缝合(ES)神经吻合术,8 只动物行纤维蛋白粘合剂(FA)修复。记录所有手术的手术时间。两组在 15 周的恢复过程中每周进行一次颊部活动分析。
大鼠的颊部活动恢复与先前的啮齿动物面神经横断和修复研究一致,在时间进程和程度上一致。缝合组和 FA 组之间的颊部活动幅度、速度或加速度没有显著差异。然而,FA 的神经吻合时间比 ES 缩短了 70%(P < 0.05)。
尽管我们发现大鼠面神经主干缝合和 FA 修复后的颊部活动恢复没有差异,但 FA 修复的手术时间明显缩短,使其成为一种有吸引力的选择。讨论了两种技术的相对优势。