Charous Steven J, Hotaling Jeffery M, Burgess Bridget D, Sappington Joshua M, Park James, Turek Grant, Foecking Eileen M
1 Loyola University of Chicago, Department of Otolaryngology-Head and Neck Surgery, Maywood, Illinois, USA.
2 Loyola University of Chicago, Stritch School of Medicine, Maywood, Illinois, USA.
Ann Otol Rhinol Laryngol. 2017 Apr;126(4):261-267. doi: 10.1177/0003489416686587. Epub 2017 Jan 10.
Facial paralysis is a devastating condition leaving patients with a myriad of aesthetic and functional consequences. Muscle-nerve-muscle (MNM) neurotization is a reinnervation technique that involves implanting an autogenous nerve graft as a conduit between an innervated "donor" muscle and a denervated "recipient" muscle. We investigated the use of MNM reinnervation, alone or in combination with electrical stimulation (ES) and testosterone propionate (TP) in comparison to nerve reanastomosis (RE), on functional recovery following rat facial nerve injury.
Thirty-one male, Sprague-Dawley rats were assigned to groups: no graft (control), MNM grafting alone (MNM), MNM grafting with ES and TP (MNM+ES+TP), or RE. Harvested right facial nerve branches were used as the MNM graft. Functional recovery was assessed by behavioral observations and electromyographic recordings.
The MNM grafting improved muscle tone and vibrissae movement. The ES+TP treatment further enhanced muscle tone as well as reduced recovery time for coordinated movement in a manner that is comparable to those of RE. Electromyographic recordings demonstrated electrical conductance across all MNM grafts.
These data have important implications for patients with unilateral paralysis from facial or laryngeal nerve injury, particularly those who are not candidates for nerve reanastomosis.
面瘫是一种严重的疾病，会给患者带来诸多美学和功能方面的后果。肌肉-神经-肌肉（MNM）神经化是一种再支配技术，涉及植入自体神经移植物作为受支配的“供体”肌肉与失神经支配的“受体”肌肉之间的导管。我们研究了与神经吻合术（RE）相比，单独使用MNM再支配或与电刺激（ES）和丙酸睾酮（TP）联合使用时，对大鼠面神经损伤后功能恢复的影响。
将31只雄性Sprague-Dawley大鼠分为几组：无移植（对照组）、单独进行MNM移植（MNM组）、MNM移植联合ES和TP（MNM+ES+TP组）或RE组。采集右侧面神经分支用作MNM移植物。通过行为观察和肌电图记录评估功能恢复情况。
MNM移植改善了肌肉张力和触须运动。ES+TP治疗进一步增强了肌肉张力，并以与RE组相当的方式缩短了协调运动的恢复时间。肌电图记录显示所有MNM移植物均有电导。
这些数据对因面部或喉返神经损伤导致单侧瘫痪的患者具有重要意义，尤其是那些不适合进行神经吻合术的患者。
