Baklacı Deniz, Kum Rauf Oğuzhan, Kulaçoğlu Sezer, Yılmaz Yavuz Fuat, Özcan Müge
Clinic of Otolaryngology Ankara Kahramankazan State Hospital, Ankara, Turkey.
Clinic of Otolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
J Int Adv Otol. 2018 Apr;14(1):63-67. doi: 10.5152/iao.2017.3593. Epub 2017 Nov 2.
MESNA (Sodium-2-mercaptoethanesulfonate) is a mucolytic substance that is used for chemically assisted tissue dissection in various surgical operations. The aim of this study was to address the issue of possible neurotoxicity from topical administration of MESNA solution on the facial nerve. We used different concentrations of MESNA solution and evaluated their effects on facial nerve by histopathological and functional analysis.
These groups were the saline administered group (control) (3 rats, 6 facial nerves), the 25% MESNA solution group (3 rats, 6 facial nerves), and the 100% MESNA solution group (3 rats, 6 facial nerves). Under general anesthesia (ketamine 150 mg/kg, xylocaine 4 mg/kg), the bilateral facial nerves of rats were dissected. The saline, 25% MESNA, and 100% MESNA solutions. Facial nerve functions of the rats were evaluated using mustachewhisker and blink reflex scores at day 20 days. On day 20, the rats were sacrificed and the buccal and marginal mandibular branches of the facial nerve were removed. The specimens were examined in terms of inflammation, granulation tissue, and foreign body reaction formation around the nerve. The functional and histopathological changes on facial nerves were compared between groups.
Mustache and blink reflex scores of the rats were 5 (normal) in both the control and study groups. There were no statistically significant differences between the three groups in terms of facial nerve functions (p=1.00). On histopathologic examination, the 25% and 100% MESNA groups had significantly more inflammation compared with the control group (p=0.038 and p=0.007, respectively). There were no statistically significant differences between the 25% and 100% MESNA groups in term of inflammation (p > 0.05). There were no statistically significant differences between the three groups in terms of foreign body reaction formation (p > 0.05).
Topical administration of MESNA solution onto the facial nerve causes increased inflammation in both the 25% and 100% concentrations. Nevertheless, it does not cause any facial nerve dysfunction.
美司钠（2-巯基乙烷磺酸钠）是一种黏液溶解剂，用于各种外科手术中的化学辅助组织解剖。本研究的目的是解决局部应用美司钠溶液对面神经可能产生的神经毒性问题。我们使用不同浓度的美司钠溶液，并通过组织病理学和功能分析评估其对面神经的影响。
这些组分别为生理盐水给药组（对照组）（3只大鼠，6条面神经）、25%美司钠溶液组（3只大鼠，6条面神经）和100%美司钠溶液组（3只大鼠，6条面神经）。在全身麻醉（氯胺酮150mg/kg，利多卡因4mg/kg）下，解剖大鼠双侧面神经。分别注射生理盐水、25%美司钠溶液和100%美司钠溶液。在第20天时，使用触须和眨眼反射评分评估大鼠的面神经功能。在第20天，处死大鼠并取出面神经的颊支和下颌缘支。检查标本中神经周围的炎症、肉芽组织和异物反应形成情况。比较各组面神经的功能和组织病理学变化。
对照组和研究组大鼠的触须和眨眼反射评分均为5（正常）。三组之间面神经功能无统计学显著差异（p = 1.00）。组织病理学检查显示，25%和100%美司钠组的炎症明显多于对照组（分别为p = 0.038和p = 0.007）。25%和100%美司钠组之间在炎症方面无统计学显著差异（p > 0.05）。三组之间在异物反应形成方面无统计学显著差异（p > 0.05）。
局部应用美司钠溶液于面神经，在25%和100%浓度时均会导致炎症增加。然而，它不会引起任何面神经功能障碍。
