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氨基胍、甲泼尼龙和褪黑素对周围性面神经吻合术中神经恢复的影响。

The effects of aminoguanidine, methylprednisolone, and melatonin on nerve recovery in peripheral facial nerve neurorrhaphy.

作者信息

Yanilmaz Muhammed, Akduman Davut, Sagun Ömer Faik, Haksever Mehmet, Yazicilar Osman, Orhan Israfil, Akpolat Nusret, Gök Uzeyir

机构信息

*Department of Otorhinolaryngology, Medical Faculty Hospital, Fatih University, Istanbul †Department of Otorhinolaryngology, Bursa Şevket Yilmaz Training and Research Hospital, Bursa ‡Department of Otorhinolaryngology, Elaziğ Medical Park Hospital, Elaziğ §Department of Medical Pathology, Inonü University Medical Faculty, Malatya, Turkey.

出版信息

J Craniofac Surg. 2015 May;26(3):667-72. doi: 10.1097/SCS.0000000000001503.

Abstract

BACKGROUND

The medications may enhance the recovery after nerve paralysis. We aimed to evaluate the effects of aminoguanidine (AG), melatonin, and methylprednisolone on peripheral facial nerve neurorrhaphy.

METHODS

The buccal branch of the facial nerve was transected and autografted in 32 New Zealand rabbits. Subjects were divided into 4 groups equally (AG, melatonin, methylprednisolone, and control). After the medical treatment latency and amplitude were measured with nerve conduction study at 3, 6, and 10 weeks. Then, coapted segments of nerve were examined microscopically. The groups were compared with each other.

RESULTS

The latent period was shortened, and the amplitudes were increased in the AG group; the latent period was shortened, and the amplitudes did not show significant change in the melatonin group with the time. There were no significant differences between the amplitudes at 3 to 6 and 3 to 10 weeks in the methylprednisolone group, and the latent period was shortened. There was no significant difference between the amplitude values at 3, 6, and 10 weeks in the control group. In the histological examination, AG had the best influence on preventing myelin degeneration and reducing the accumulation of myelin debris. Considering the increase in collagen fibers, the best results were achieved in the melatonin group. The degree of myelin-axonal degeneration was higher in the methylprednisolone group. The degree of collagen fiber increase, axonal degeneration, myelin degeneration, and the accumulation of myelin debris were detected quite high in the control group.

CONCLUSIONS

Aminoguanidine and melatonin alone achieved an increase in regeneration after peripheral facial nerve neurorrhaphy, but methylprednisolone did not. The best healing was determined in the AG group.

摘要

背景

药物可能会促进神经麻痹后的恢复。我们旨在评估氨基胍(AG)、褪黑素和甲基强的松龙对外周面神经吻合术的影响。

方法

将32只新西兰兔的面神经颊支切断并进行自体移植。将实验对象平均分为4组(AG组、褪黑素组、甲基强的松龙组和对照组)。在药物治疗后,于第3、6和10周通过神经传导研究测量潜伏期和波幅。然后,对吻合的神经段进行显微镜检查。对各组进行相互比较。

结果

AG组潜伏期缩短,波幅增加;褪黑素组潜伏期缩短,波幅随时间未显示出显著变化。甲基强的松龙组在3至6周和3至10周时波幅无显著差异,潜伏期缩短。对照组在3、6和10周时波幅值无显著差异。在组织学检查中,AG对预防髓鞘变性和减少髓鞘碎片积累的影响最佳。考虑到胶原纤维的增加,褪黑素组取得了最佳结果。甲基强的松龙组髓鞘-轴突变性程度较高。对照组中胶原纤维增加、轴突变性、髓鞘变性和髓鞘碎片积累的程度均较高。

结论

单独使用氨基胍和褪黑素可促进外周面神经吻合术后的再生,但甲基强的松龙不能。AG组愈合效果最佳。

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