Niimi Yosuke, Matsumine Hajime, Takeuchi Yuichi, Hironobu Osaki, Tsunoda Satoshi, Miyata Mariko, Yamato Masayuki, Sakurai Hiroyuki
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Microsurgery. 2019 Jan;39(1):70-80. doi: 10.1002/micr.30291. Epub 2018 Jan 8.
This study investigated the potential of collagen-coated polyglycolic acid (PGA) tube with interpositional jump graft (IPJG) in rat.
A total of 16 Lewis rats were used in this study. Facial nerve paralysis was created by ligating facial nerve trunk with a ligature clip. The rats were divided into 3 groups. Nerve conduit group (n = 6) were treated by IPJG with collagen-coated PGA tubes between the facial nerve trunks and the hypoglossal nerves. Autograft group (n = 6) were treated by IPJG with the greater auricular nerves. As the control group (n = 4), non-treated-model rats with facial nerve paralysis were used. The number of myelinated fibers, fiber diameter, axon diameter, myelin thickness, and g-ratio, were analyzed histologically at 13 weeks after surgery. Compound muscle action potential (CMAP) and retrograde tracing were measured.
Although the number of myelinated fibers in autograft group (1957 ± 775) had significantly higher than that of nerve conduit group (90 ± 41, P < .05), the nerve conduit group showed the regeneration of myelinated nerve axons. CMAP amplitude values of the autograft (4706 ± 1154 µV) and the nerve conduit groups (4119 ± 1397 µV) were significantly higher than that of the control group (915 ± 789 µV, P < .05). Retrograde tracing confirmed the double innervation of mimetic muscles by the facial and hypoglossal nucleus in both groups.
This study showed histologically and physiologically the superior effectiveness of performing IPJG with a collagen-coated PGA conduit in a rat model.
本研究探讨了胶原蛋白包被的聚乙醇酸（PGA）管联合间置跳跃移植（IPJG）在大鼠体内的应用潜力。
本研究共使用了16只Lewis大鼠。通过用结扎夹结扎面神经干造成面神经麻痹。将大鼠分为3组。神经导管组（n = 6）采用IPJG，在面神经干和舌下神经之间植入胶原蛋白包被的PGA管进行治疗。自体移植组（n = 6）采用IPJG，用耳大神经进行治疗。作为对照组（n = 4），使用未治疗的面神经麻痹模型大鼠。在术后13周对有髓纤维数量、纤维直径、轴突直径、髓鞘厚度和g比值进行组织学分析。测量复合肌肉动作电位（CMAP）和逆行示踪。
虽然自体移植组的有髓纤维数量（1957 ± 775）显著高于神经导管组（90 ± 41，P < 0.05），但神经导管组显示有髓神经轴突发生了再生。自体移植组（4706 ± 1154 μV）和神经导管组（4119 ± 1397 μV）的CMAP振幅值显著高于对照组（915 ± 789 μV，P < 0.05）。逆行示踪证实两组中面部和舌下神经核对面部表情肌均有双重支配。
本研究在组织学和生理学上表明，在大鼠模型中使用胶原蛋白包被的PGA导管进行IPJG具有更好的效果。
