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猫颞骨内面神经中纤维蛋白组织粘合剂、神经外膜缝合与自然愈合的比较。

Comparison between fibrin tissue adhesive, epineural suture and natural union in intratemporal facial nerve of cats.

作者信息

Bento R F, Miniti A

机构信息

School of Medicine, University of São Paulo, Brazil.

出版信息

Acta Otolaryngol Suppl. 1989;465:1-36. doi: 10.3109/00016488909138697.

Abstract

Our objective was to study intratemporal anastomosis of the facial nerve in cats. Clinical, electrophysiological and histological results of the use of fibrin tissue adhesive, epineural suture and natural adhesion were compared. The 30 adult cats studied had undergone mastoidectomy exposure, and section of the facial nerve 1 cm before its exit from the stylomastoid foramen. Anastomosis was then undertaken, using epineural suture combined with stabilization through fibrinic tissue adhesive, and union of the stumps without stabilizing them. Each type of anastomosis was carried out in 10 animals. Clinical, electrophysiological and histological assessments of both the site of anastomosis and the ventral branch of the facial nerve followed the aforementioned procedures. By means of statistical analysis, the authors reached the following conclusions: 1) Considering the clinical assessment per se, both groups with fibrinic tissue adhesive and suture showed similar features and results, which in both cases were better than those following natural union. 2) Considering the electrophysiological results per se, the use of fibrin tissue adhesive was superior to any other method used. 3) Considering the histological examination per se, both groups with fibrin tissue adhesive and suture revealed similar features which were more favourable than those shown by natural union. 4) In the overall comparison of the various parameters in the three groups, the use of fibrin tissue adhesive achieved better results than any other method. Based on the results of this study, the authors conclude that the use of fibrin tissue adhesive has technical advantages, and that the results of this use outweigh those achieved with both epineural suture and natural union. The authors recommend this technique as the most beneficial to be resorted to, for intrapetrous anastomosis of the facial nerve.

摘要

我们的目的是研究猫面神经的颞内吻合。比较了使用纤维蛋白组织粘合剂、神经外膜缝合和自然粘连的临床、电生理和组织学结果。所研究的30只成年猫均接受了乳突切除暴露,并在面神经从茎乳孔穿出前1厘米处切断。然后进行吻合,采用神经外膜缝合并通过纤维蛋白组织粘合剂进行固定,以及在不固定残端的情况下使残端愈合。每种吻合方式在10只动物中进行。按照上述程序对面神经吻合部位和腹侧支进行临床、电生理和组织学评估。通过统计分析,作者得出以下结论:1)就临床评估本身而言,使用纤维蛋白组织粘合剂和缝合的两组表现出相似的特征和结果,这两种情况均优于自然愈合后的结果。2)就电生理结果本身而言,使用纤维蛋白组织粘合剂优于所使用的任何其他方法。3)就组织学检查本身而言,使用纤维蛋白组织粘合剂和缝合的两组显示出相似的特征,比自然愈合所显示的特征更有利。4)在三组各种参数的总体比较中,使用纤维蛋白组织粘合剂取得的结果优于任何其他方法。基于本研究结果,作者得出结论,使用纤维蛋白组织粘合剂具有技术优势,且这种使用方法的结果优于神经外膜缝合和自然愈合所取得的结果。作者推荐将该技术作为面神经岩内吻合最有益的方法。

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