Zhu Yun, Liu Shengwen, Zhou Shanghui, Yu Zhiwei, Tian Zhen, Zhang Chenping, Yang Wenjun
Shanghai, People's Republic of China From the Departments of Oral and Maxillofacial Head and Neck Oncology and Oral Pathology, Ninth People's Hospital College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology.
Plast Reconstr Surg. 2015 Feb;135(2):331e-339e. doi: 10.1097/PRS.0000000000000992.
The use of vascularized nerve graft models has been limited because of the complexity of the operation. The authors sought to develop a simple and effective rabbit model for facial nerve repair and evaluated its advantages over conventional nerve grafts.
Rabbits were divided into three groups consisting of six rabbits each. The central auricular nerve and its nutrient vessels were used as a vascularized graft. Rabbits were grafted with a vascularized facial nerve graft (vascularized nerve graft group), with a free nerve graft (free nerve graft group), or with a vascularized nerve graft and a free nerve graft on each side of the face (vascularized nerve graft/free nerve graft group). Four months after surgery, facial performance and electrophysiologic monitoring were evaluated. The rabbits were then killed to prepare the nerve specimens for histologic, immunohistochemical, and transmission electron microscope study.
At 4 months after the facial nerve repair, the functional recovery of the facial nerve was observed and analyzed. The side grafted with vascularized nerve graft was superior to the side grafted with free nerve graft. Regenerated nerve fibers were observed in all groups, and rabbits grafted with vascularized nerve grafts had more regenerated axons than those that underwent free nerve grafting, although the regenerated nerves were not as good as the natural nerves.
This study demonstrates that it is feasible to establish a vascularized nerve graft model in rabbits. The model offers the obvious advantages of operability and reliability. The vascularized nerve graft is demonstrated to have a superior value for facial nerve repair.
由于手术操作复杂，带血管神经移植模型的应用受到限制。作者试图开发一种简单有效的兔面神经修复模型，并评估其相对于传统神经移植的优势。
将兔子分为三组，每组六只。采用耳中央神经及其营养血管作为带血管移植物。分别给兔子移植带血管面神经移植物（带血管神经移植组）、游离神经移植物（游离神经移植组），或在面部两侧分别移植带血管神经移植物和游离神经移植物（带血管神经移植/游离神经移植组）。术后四个月，评估面部功能和电生理监测情况。然后处死兔子，制备神经标本用于组织学、免疫组织化学和透射电子显微镜研究。
面神经修复术后四个月，对面神经功能恢复情况进行观察和分析。移植带血管神经移植物的一侧优于移植游离神经移植物的一侧。所有组均观察到再生神经纤维，与接受游离神经移植的兔子相比，移植带血管神经移植物的兔子有更多再生轴突，尽管再生神经不如天然神经。
本研究表明在兔体内建立带血管神经移植模型是可行的。该模型具有明显的可操作性和可靠性优势。带血管神经移植物在面神经修复方面具有更高价值。
