Lu H B, Jia Y S, Guo X L, Yu H, Wu S J
Department of Oral and Maxillofacial Surgery,Zhongshan Hospital Affiliated to Dalian University,Dalian,116001,China.
Department of Endodontics,Dalian Stomatological Hospital Affiliated to Dalian Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Oct 5;31(19):1496-1500;1503. doi: 10.13201/j.issn.1001-1781.2017.19.008.
The purpose of this study was to produce chitosan nerve conduit in order to investigate the feasibility of chitosan nerve conduit combined with autologous platelet-rich plasma (PRP) for repairing facial nerve defects.Forty New Zealand white rabbits were randomly divided into four groups (n=10 in each group).Establishment of the facial nerve defect model of the upper buccal branches was placed in the nerve regeneration catheter and injected with the same amount of PRP and saline. The PRP was injected into the chitosan nerve conduit as group A. The physiological saline was injected into the chitosan nerve conduit as group B. The physiological saline was injected into the silicone tube as group C. The PRP was injected into the silicone tube as group D. Eight weeks later,facial nerve gross observation,facial nerve electrophysiological tests,histological observation,image analysis,valuation of nerve regeneration recovery were detected.Five patients were lost to follow up (all five in the modified Semont group),and three patients failed to complete treatment (all three in the Epley group). The sequelae at the 3rd day and one week after modified Semont maneuver were 27 and 9,while 41 and 15 in Epley group. The efficacy rates at the 3rd day and one week after modified Semont maneuver were 91.7% and 98.3%,and 91.9% and 96.8% in Epley group retrospectively. The sequelae and short-term effective rate of patients in modified Semont group was no difference when compared with that in Epley group (>0.05).The chitosan nerve conduit combined with PRP has a certain effect on the repair of facial nerve defects and is expected to be applied to the repair of clinical facial nerve defects.
本研究旨在制备壳聚糖神经导管，以探讨壳聚糖神经导管联合自体富血小板血浆（PRP）修复面神经缺损的可行性。将40只新西兰白兔随机分为四组（每组n = 10）。建立颊上支面神经缺损模型，将其置于神经再生导管中，并注入等量的PRP和生理盐水。A组将PRP注入壳聚糖神经导管；B组将生理盐水注入壳聚糖神经导管；C组将生理盐水注入硅胶管；D组将PRP注入硅胶管。8周后，进行面神经大体观察、面神经电生理测试、组织学观察、图像分析、神经再生恢复评估。5例患者失访（均在改良Semont组），3例患者未完成治疗（均在Epley组）。改良Semont手法后第3天和1周的后遗症分别为27例和9例，Epley组分别为41例和15例。改良Semont手法后第3天和1周的有效率分别为91.7%和98.3%，Epley组回顾性分析分别为91.9%和96.8%。改良Semont组与Epley组患者的后遗症及近期有效率比较，差异无统计学意义（>0.05）。壳聚糖神经导管联合PRP对面神经缺损修复有一定作用，有望应用于临床面神经缺损的修复。
