Smith K G, Robinson P P
Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, England.
J Oral Maxillofac Surg. 1995 Sep;53(9):1052-62. doi: 10.1016/0278-2391(95)90124-8.
This study compares three methods of lingual nerve defect repair.
The recovery of the mechanosensitive and thermosensitive afferent fibers in the lingual branch of the trigeminal nerve in cats was studied using electrophysiological techniques 24 weeks after the removal of a segment of lingual nerve and repair of the defect by one of three methods. The nerve gap was closed by either stretching the nerve ends together and repairing under tension, insertion of a sural nerve graft, or use of a freeze-thawed muscle graft. The characteristics of the regenerated fibers were investigated and the data were compared with that from normal control animals.
After nerve repair, integrated whole-nerve activity evoked by thermal (cold) stimulation of the tongue was smaller than in the controls, but there were no differences between the repaired groups. However, recordings made from single axons in filaments dissected from the nerve revealed differences between the groups; the units were less sensitive after either method of grafting than after stretch repair.
It is concluded that repair of a short gap in the lingual nerve by stretch repair with an end-to-end anastomosis, even with some degree of tension, is followed by better recovery than by grafting. However, where a graft is necessary, a similar level of recovery will result from use of a frozen muscle graft or a sural nerve graft.
本研究比较三种舌神经缺损修复方法。
采用电生理技术，研究猫舌神经节段切除并通过三种方法之一修复缺损24周后，三叉神经舌支中机械敏感和温度敏感传入纤维的恢复情况。神经缺损通过将神经末端拉拢并在张力下修复、插入腓肠神经移植物或使用冻融肌肉移植物来闭合。研究再生纤维的特征，并将数据与正常对照动物的数据进行比较。
神经修复后，舌部热（冷）刺激诱发的全神经综合活动低于对照组，但修复组之间无差异。然而，从神经中分离出的细丝中的单根轴突记录显示出各组之间的差异；与拉伸修复相比，两种移植方法后的单位敏感性较低。
得出结论，舌神经短节段缺损采用端端吻合拉伸修复，即使存在一定程度的张力，其恢复情况也优于移植。然而，在需要移植的情况下，使用冻融肌肉移植物或腓肠神经移植物可获得相似的恢复水平。
