以化学去细胞法处理同种异体神经与周围静脉伴行修复面神经缺损

背景：有研究表明化学去细胞法处理的同种异体神经修复面神经缺损可以取得较好的修复效果。 目的：在化学去细胞法处理同种异体神经的基础上探索一种修复面神经缺损更有效的修复方式。  方法：将新西兰大白兔随机分为2组,实验组制备面神经颊支缺损动物模型,采用经化学去细胞的同种异体腓肠神经进行移植,且与伴行静脉行外膜缝合;对照组在同样位置的远近端分别切断面神经,但不破坏被切断神经与周围组织的正常解剖关系,再切断处行外膜缝合桥接。 结果与结论：修复后3个月两组兔均存活,面部表情基本对称,胡须活动正常,神经移植处未见明显瘢痕及神经瘤形成。电镜观察结果显示,实验组与对照组右侧面神经颊支传导速度,移植体远端吻合口附近5.0 mm段有髓神经纤维数量,靶肌肉运动终板计数均差异无显著性意义(P > 0.05)。结果证实,化学去细胞同种异体神经与周围静脉伴行修复家兔面神经缺损的方法可以达到与自体面神经原位移植相似的修复效果。

Chemically extracted acellular allogenic nerve and accompanying peripheral vein for repair of facial nerve defects

BACKGROUND:Studies have showed that repair of facial nerve defect in rabbit with chemically extracted acellular allogenic nerve can achieve good effect. OBJECTIVE:To explore a more effective operation means to repair facial nerve defects on the basis of chemically extracted acellular allogenic nerve. METHODS:New Zealand rabbits were randomly divided into the experimental group and the control group. The experimental group received chemically extracted acellular allogenic sural nerve transplantation and then received adventitial suture with accompanying peripheral vein to prepare the animal models of defects of buccal branches of facial nerve; the control group received the autologous facial nerve in situ anastomosis. The rabbits in the control group were treated with facial nerve cutting on the proximal and distal part of the same position that did not damage the normal anatomy relations between the cut nerve and the surrounding tissues, then the adventitia suture bridge was performed at the cutting site.  RESULTS AND CONCLUSION:At 3 months after operation, the animals of both groups survived well with basically symmetrical facial expression and normal moustache swinging, no formation of obvious scars and neuroma could be seen at the neural transplantation site. The microscope observation results showed that there were no significant differences in the conduction velocity of right facial nerve buccal branch, number of myelinated nerve fibers in the 5.0 mm segment of graft distal anastomosis and the count of target muscle motor endplate between two groups (P > 0.05). Repairing of rabbit facial nerve defects with chemically extracted acellular allogenic nerve and accompanying peripheral vein shows a postoperative result similar to that of autologous facial nerve in situ anastomosis.