Kökten Numan, Eğilmez Oğuz Kadir, Kalcıoğlu M Tayyar, Baran Mustafa, Ekici A Işın Doğan
Department of Otorhinolaryngology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey.
Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Clin Exp Otorhinolaryngol. 2018 Sep;11(3):174-180. doi: 10.21053/ceo.2017.00864. Epub 2018 Mar 29.
To investigate neurotoxic effect of bone cement (BC) on facial nerve by using electrophysiological and histopathological methods.
This study included 20 male albino Wistar rats, divided into four equal groups. Group A was designed as the control group, while group B was sham group. In the group C, BC solution was dropped onto the facial nerve trunks of rats and washed with physiological saline after 5 seconds. In the group D, BC solution was dropped onto the facial nerve trunks of rats and after allowing 5 minutes to dry, wounds were closed. Pre- and postoperative (on 4th week) evoked electromyography (EMG) measurements were done. For histopathological assessments, the rats were euthanized and tissue samples of facial nerve and surrounding areas were collected.
According to the wave amplitude levels of evoked EMG, postoperative amplitude levels of group D were significantly decreased, compared to preoperative amplitude levels (=0.043). We found no statistically significant difference in inflammation among the groups. In none of the groups, foreign body reaction and granulation tissue were not detected in any of the groups. In addition, degeneration in axon, myelin, or perineural nets was not detected in any of the groups.
This study results suggest that BC has no direct toxicity on facial nerve, while it has indirect effects, by decreasing amplitude. Therefore, we conclude that direct contact of BC with nerve should be avoided, and the area should be cleaned by aspiration or washing with physiological saline in case of contact.
采用电生理和组织病理学方法研究骨水泥(BC)对面神经的神经毒性作用。
本研究纳入20只雄性白化Wistar大鼠,分为四组,每组数量相等。A组为对照组,B组为假手术组。C组将BC溶液滴在大鼠面神经干上,5秒后用生理盐水冲洗。D组将BC溶液滴在大鼠面神经干上,待其干燥5分钟后缝合伤口。术前及术后(第4周)进行诱发肌电图(EMG)测量。为进行组织病理学评估,将大鼠安乐死并收集面神经及周围区域的组织样本。
根据诱发EMG的波幅水平,D组术后波幅水平与术前相比显著降低(P=0.043)。各组之间炎症无统计学显著差异。所有组均未检测到异物反应和肉芽组织。此外,所有组均未检测到轴突、髓鞘或神经周网的变性。
本研究结果表明,BC对面神经无直接毒性,但通过降低波幅有间接影响。因此,我们得出结论,应避免BC与神经直接接触,若发生接触,应通过吸引或用生理盐水冲洗来清洁该区域。