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新型异源纤维蛋白密封剂联合低强度激光疗法(LLLT)用于面神经颊支修复

The new heterologous fibrin sealant in combination with low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve.

作者信息

Buchaim Daniela Vieira, Rodrigues Antonio de Castro, Buchaim Rogerio Leone, Barraviera Benedito, Junior Rui Seabra Ferreira, Junior Geraldo Marco Rosa, Bueno Cleuber Rodrigo de Souza, Roque Domingos Donizeti, Dias Daniel Ventura, Dare Leticia Rossi, Andreo Jesus Carlos

机构信息

Human Morphophysiology (Anatomy), Faculty of Medicine, University of Marilia (UNIMAR), Marilia, SP, Brazil.

Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.

出版信息

Lasers Med Sci. 2016 Jul;31(5):965-72. doi: 10.1007/s10103-016-1939-2. Epub 2016 Apr 25.

Abstract

This study aimed to evaluate the effects of low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve with two surgical techniques: end-to-end epineural suture and coaptation with heterologous fibrin sealant. Forty-two male Wistar rats were randomly divided into five groups: control group (CG) in which the buccal branch of the facial nerve was collected without injury; (2) experimental group with suture (EGS) and experimental group with fibrin (EGF): The buccal branch of the facial nerve was transected on both sides of the face. End-to-end suture was performed on the right side and fibrin sealant on the left side; (3) Experimental group with suture and laser (EGSL) and experimental group with fibrin and laser (EGFL). All animals underwent the same surgical procedures in the EGS and EGF groups, in combination with the application of LLLT (wavelength of 830 nm, 30 mW optical power output of potency, and energy density of 6 J/cm(2)). The animals of the five groups were euthanized at 5 weeks post-surgery and 10 weeks post-surgery. Axonal sprouting was observed in the distal stump of the facial nerve in all experimental groups. The observed morphology was similar to the fibers of the control group, with a predominance of myelinated fibers. In the final period of the experiment, the EGSL presented the closest results to the CG, in all variables measured, except in the axon area. Both surgical techniques analyzed were effective in the treatment of peripheral nerve injuries, where the use of fibrin sealant allowed the manipulation of the nerve stumps without trauma. LLLT exhibited satisfactory results on facial nerve regeneration, being therefore a useful technique to stimulate axonal regeneration process.

摘要

本研究旨在评估低强度激光疗法(LLLT)对采用两种手术技术修复面神经颊支的效果:端端神经外膜缝合和用异源纤维蛋白封闭剂吻合。42只雄性Wistar大鼠被随机分为五组:对照组(CG),面神经颊支被采集但未受伤;(2)缝合实验组(EGS)和纤维蛋白实验组(EGF):面神经颊支在面部两侧横断。右侧进行端端缝合,左侧使用纤维蛋白封闭剂;(3)缝合加激光实验组(EGSL)和纤维蛋白加激光实验组(EGFL)。所有动物在EGS组和EGF组接受相同的手术操作,并联合应用LLLT(波长830nm,光功率输出30mW,能量密度6J/cm²)。五组动物在术后5周和术后10周实施安乐死。所有实验组面神经远端残端均观察到轴突发芽。观察到的形态与对照组纤维相似,以有髓纤维为主。在实验末期,除轴突面积外,EGSL在所有测量变量上呈现出与CG最接近的结果。所分析的两种手术技术在治疗周围神经损伤方面均有效,其中使用纤维蛋白封闭剂可在无创伤的情况下操作神经残端。LLLT在面神经再生方面显示出满意的结果,因此是刺激轴突再生过程的一种有用技术。

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