CNTF对端侧吻合后面神经再生作用的实验研究

目的 :研究睫状神经营养因子 (CNTF)对周围面神经端侧缝合后促神经再生的作用。方法 :2 4只成年家兔随机分为 3组 ,兔双侧面神经上颊支切断后与同侧外膜开窗的下颊支作端侧吻合。右侧为实验侧 ,术后局部给予CNTF ,左侧生理盐水 ,作为对照侧。分别于术后 3、5、12周取材 ,进行大体观察和面神经功能评分、神经组织学、电生理、透射电镜等检查。结果 :各组实验侧颊支有髓神经数、运动神经传导速度、面神经功能评分均高于对照侧 (P<0 .0 5 )。实验侧颊支神经成熟程度优于对照侧。结论 :CNTF在提高神经端侧吻合后侧支萌出率和减轻失神经肌肉萎缩方面有积极的作用     

BDNF对端侧吻合面神经再生作用的研究

目的：探讨脑源性神经营养因子（BDNF）对面神经端侧吻合后促进神经再生的作用。方法：30只家兔随机分2组,将双侧离断的面神经上颊支远端与同侧外膜开窗的下颊支行端侧吻合。术后给予BDNF的为实验组,给予生理盐水的为对照组。分别于术后2、4、8周取材,采用电生理,光镜,透射电镜等检测方法。结果：实验组神经传导速度、动作电位、组织学形态学定量分析等指标明显优于对照组。结论：BDNF对面神经端侧吻合后神经再生有明显促进作用。     

电刺激对端侧缝合后面神经再生作用的实验研究

多项实验结果证实远端、负极电流的直流电场与脉冲电流均有促进周围神经再生的作用。本实验主要借鉴这两方面的成果 ,研究经皮肤电刺激在神经端侧缝合后对面神经再生的作用。结果证实电刺激能提高面神经端侧缝合后侧支的萌出率和减轻失神经肌肉的萎缩。1　材料与方法1.1　动物分组与实验方法选用成年家兔 2 4只 ,不分雌雄随机分为Ａ、Ｂ、Ｃ 3个组 :术后 3周组 ,术后 5周组和术后 15周组。右侧为实验侧 ,左侧为自身对照侧。手术显微镜下仔细游离面神经分支 ,在无张力状态下用刀片将颊支切断 ,在颈支外膜上开窗约 1.5ｍｍ× 1ｍｍ大小 ,用 11…     

甲壳素导管引导面神经再生的研究

目的 研究甲壳素导管对面神经再生的引导作用。方法 用甲壳素导管套接修复兔面神经颊支10mm缺损，分别于术后12和24周应用诱发电位仪及光镜、电镜观察再生神经电生理功能和组织形态、超微结构恢复情况。结果 实验组与自体神经移植对照组再生神经各项电生理和形态结构指标的差异无显著性（P＞0.05）。结论 可吸收性甲壳素神经导管能有效地引导面神经再生并恢复其功能，有一定的临床应用前景。     

面神经端侧吻合与游离移植修复对比实验研究

目的 :为了比较面神经端侧吻合与耳大神经移植的效果。方法 :选用体重 2 .0～ 2 .5kg大白兔 ,右侧切掉面神经上颊支 2cm ,远心端吻合到外膜开窗的下颊支上。左侧同样切掉面神经上颊支 2cm ,取耳大神经行端 -端神经游离移植修复。结果 :3个月后运动神经传导速度分别为 2 3.5 6± 4 .4 6m/s ,2 2 .86± 5 .2m/s(P >0 .0 5 ) ,两组均可见大量神经纤维和髓鞘 ,有髓神经纤维计数分别为 6 4 .6 6± 2 .4 8,6 3.84± 2 .78个 /每高倍视野 (P >0 .0 5 )。结论 :正常神经发出侧芽能通过端侧缝合口长入远端神经 ,使变性神经再神经化 ,面神经端侧吻合能取得与神经移植相近的结果。     

去细胞异体面神经移植修复兔面神经缺损的实验研究

目的：探讨化学去细胞异体全面神经修复兔全面神经缺损对面神经及肌功能恢复的作用，比较各支之间神经再生速度的差异。方法：造成兔左侧面神经主干加分支共2cm的缺损，采用去细胞异体全面神经进行外膜缝合桥接缺损，并设自体面神经原位移植作为对照。术后3、6个月进行颊支、颞支神经电生理检测以及运动终板染色，采用SPSS11．0软件包对数据进行t检验。结果：术后6个月，实验组兔面形已经基本对称，闭眼完全。实验组及对照组颊支传导速度分别为（50．63±3．28）m／s和（54．22±4．78）m／s，颞支传导速度分别为（23．95±4．83）m／s及（25．37±5．74）m／s，均无显著性差异（P〉0．05）。颊支传导速度显著快于颞支（P〈0．01）。口轮匝肌乙酰胆碱酯酶染色可见复筵的运动终板，每高倍视野终板的数量在实验组及对照组分别为（8±1）个和（12±3）个（P〈0．05），实验组终板的纵、横径均小于对照组（P〈0．01），但与健侧相比均有显著性差异（P〈0．01）。结论：化学去细胞异体全面神经修复兔2cm全面神经缺损，可恢复面神经的运动及传导功能，具有潜在的临床应用前景。     

睫状神经营养因子神经生长因子对面神经再生影响的比较研究

目的 研究CNTF和NGF对损伤后面神经再生的作用差别，为临床上选择高效的神经营养因子提供实验依据。方法 选用42只新西兰白兔，将其双侧面神经上颊支离断后套入硅胶管，吻合神经断端，并将硅胶管两端与神经外膜吻合后，向套管内注射相同剂量的CNTF液（A组）、NGF液（B组）以及生理盐水（C组）。于术后1、2、4、8周采用电生理、光镜1、透射电镜等手段来检测。结果 术后2周、4周，A、B二组不论是神经传导速率还是组织学形态均明显优于C组；就实验组相互比较而言，A组的作用效果优于B组。8周以后，A、B、C三组无明显差别。结论 局部应用外源性CNTE或NGF短期内均可促进面神经再生，且CNTF的作用效果明显优于NGF。     

面神经端侧吻合与端端吻合疗效比较的实验研究

目的 :比较面神经损伤后端侧吻合与端端吻合方法的治疗效果。方法 :大耳白兔 2 4只 ,左侧上颊神经切断后作端端吻合。右侧上颊神经切断后 ,远中断端与下颊支侧方外膜开窗处作支间端侧吻合。分别于术后 1月、2月、3月进行肌电图测试及组织学观察。结果 :端侧吻合与端端吻合相比较 ,第 1、2月肌电图诱发电位潜伏期延长、波幅降低 ;有髓神经纤维数减少。第 3个月两种方法各项指标无显著性差异。结论 :端侧吻合早期神经再生质量不及端端吻合 ,晚期效果比较接近。     

应用面神经次要分支修复重要分支的效果观察

目的:探讨应用面神经次要分支修复重要分支的可行性及临床效果.方法:应用面神经颈支修复下颌缘支,上颊支修复颧支缺损.测量缺损的神经长度后,切断颈支和上颊支远端,旋转至需要修复的下颌缘支及颧支远断端.手术在双人双目手术显微镜下进行,用9-0无损伤缝合线吻合2-4针.应用颈支修复下颌缘支缺损5例,应用上颊支修复颧支缺损7例.结果:颈支修复下颌缘支5例,术后3个月恢复2例,术后6个月恢复3例.上颊支修复颧支7例,术后3-4个月功能完全恢复.结论:应用面神经颈支修复下颌缘支缺损及应用上颊支修复颧支缺损在临床上是完全可行的,并可取得较好的修复效果.     

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目的 探讨应用面神经分支转位吻合修复面神经分支缺损的疗效.方法 选择2005年10月至2010年9月濮阳市油田总医院口腔科收治的外伤性面神经损伤患者27例(损伤神经32支).应用携带肌筋膜的上颊支吻合颧支远心断端,颈支吻合下颌缘支远心断端.结果 术后1个月受损神经功能恢复达到2级以上10支,占31％;术后6个月达到2级及以上30支,占96.8％.结论 携带肌筋膜的面神经转位吻合修复面神经颧支、下颌缘支缺损神经,是一种有效的面神经功能重建的手术方法.     

端侧神经吻合配合NGF修复面神经缺损的实验研究

目的:通过对端侧神经吻合术配合神经生长因子(NGF)修复面神经缺损的研究,探索简便、省时、不损伤供神经而又可获得较好神经再生效果的修复神经损伤的新方法。方法:!成年健康新西兰大白兔24只,随机分成3组,每组8只。(1)神经移植组:切断兔面神经的耳眼睑神经分支1.2cm后用神经干移植修复缺损;(2)单纯端侧神经缝合组:切断兔面神经的耳眼睑神经分支1.2cm后不用神经干移植修复,而将其远颅段断端向下吻合于面神经颊上神经分支的侧方,采用外膜、束膜均切开“开窗”的端侧神经吻合术;(3)端侧神经缝合术配合NGF修复神经缺损组:手术处理同(2)组,但在术中及术后配合局部NGF的注射使用。术后4、8、12、16周采用肉眼观察睑裂大小,并作组织学检查,观察吻合口近颅及远颅段的神经轴突数和再生髓鞘的厚度。结果:3组均可见明确的神经再生现象,但统计学上无显著性差异。结论:!端侧神经吻合术可作为一种较好的面神经修复手段,简便、省时、不损伤供神经而又可获得较好的神经再生效果。     

Influences of Tongue Protrusion on Rhythmical Jaw Movement in Rats

Influences of tongue protrusion on rhythmical jaw movement were examined in lightly anesthetized adult rats. Both medial and lateral branches of the hypoglossal (XII) nerve on the right side were sectioned. The lateral branch of the XII nerve on the left side was also sectioned, and the medial branch was placed on stimulating electrodes. Intermittent electrical stimulation was delivered to the medial branch of the XII nerve to protrude the tongue, which was monitored by a tension-measuring device. Rhythmical jaw movements were elicited by electrical stimulation of the masticatory area of the cerebral cortex and were monitored using a magnet and magnet sensors. The following four major results were obtained: 1) the minimum opening position during cortically evoked chewing was significantly lowered by tongue protrusion, while no change was shown in the maximum opening position, 2) the lowering of the minimum opening position by tongue protrusion was consistent before and after mucosal anesthesia of the oral cavity, 3) the minimum and maximum opening positions were not altered by stimulation of the peripheral cut end of the medial branch of the XII nerve, and 4) the minimum opening position was lowered by stimulation of the central cut end of the medial branch of the XII nerve. These results suggest that the lowering of the minimum opening position by tongue protrusion is probably elicited from afferent signals through the medial branch of the XII nerve.     

Communication of infraorbital nerve and facial nerve: anatomic and histologic study

The maxillary nerve, second division of the trigeminal nerve, is entirely sensory. It has been reported that drooling may occur later in the event of fracture of the zygoma in which hypesthesia prevails. The aim of the study is to elucidate additional detailed anatomy of the infraorbital plexus, consisting of the superior labial branch of the infraorbital nerve and facial nerve in the cheek. The authors dissected infraorbital nerves and facial nerves in 16 cadavers. Most terminals of the zygomatic branch of the facial nerve emerged from under the levator labii superiors and zygomatic muscle and infraorbital nerve. A hazardous zone of infraorbital plexus is found in a circle 36 mm in diameter. Its center is located 22 mm below the inferior orbital foramen. This hazardous zone of infraorbital plexus should be kept in mind when performing any procedures related to zygoma, maxilla, or deep cheek injuries.     

兔骨髓间充质干细胞修复面神经缺损的初步研究

目的:初步观察骨髓间充质干细胞(MSCs)在面神经缺损修复中的作用。方法:抽取兔骨髓液经Percoll液离心得到单个核细胞,经体外培养、纯化后获得兔骨髓MSCs。15只新西兰白兔的两侧面神经上颊支分别造成12mm的缺损,一侧硅胶管套管连接后植入MSCs,另一侧单纯硅胶管套管。于术后第4、8、16周行大体观察,测定神经传导速度,处死动物后作组织学检查。结果:第4周时双侧管内未见明显再生神经纤维;第8周和16周时,双侧管内可见再生神经纤维。神经电生理测定和有髓神经纤维计数结果显示,MSCs侧优于单纯套管侧(P<0.05)。结论:MSCs可促进面神经缺损的修复,提示MSCs可应用于修复外周神经缺损。     

Facial nerve function following temporomandibular joint surgery using the preauricular approach.

Sixty-eight patients (83 temporomandibular joints) consecutively operated on who had a variety of temporomandibular joint operations using a preauricular approach were assessed for facial nerve function following surgery. Nine patients (10.84%) showed signs of facial nerve injury in which the temporal and zygomatic branches were involved. The incidence of facial nerve injury was greater in patients who had undergone previous temporomandibular joint surgery (17.64%) than in patients with previously unoperated joints (9%). Normal facial nerve function returned in 9 to 14 weeks except in one patient who showed a mild deficit of the zygomatic branch at 20 weeks. The nature and duration of the surgical procedure did not correlate with facial nerve injury. Scarring of tissues as a result of previous temporomandibular joint surgery may significantly increase the risk of facial nerve injury during subsequent temporomandibular joint surgery.     

Facial nerve section induces transient changes in sensitivity to methacholine and in acetylcholine synthesis in the rat parotid gland

Nerves exert long-term influences on the salivary glands as e.g. revealed by increases in sensitivity to secretagogues following nerve degeneration. The objective was to study the effect of unilateral facial nerve section on the sensitivity of the parotid secretory cells 2-3 weeks postoperatively, i.e. at a time when the sensitisation is thought to be fully developed. Comparisons were made between pair of glands. However, no increase in the secretory response to increasing intravenous doses of methacholine of the duct-cannulated gland on the operated side was found; neither were any decrease in the acetylcholine synthesizing capacity of the gland found. In contrast, a slight supersensitivity had developed 1 week postoperatively supporting the idea of a functional influence of the facial nerve on the secretory cells under normal conditions. Furthermore, the results combined with the previous finding of ours of decreased acetylcholine synthesis in the parotid gland 1 week after facial nerve section, suggest a rapid restitution of the nervous influence on the secretory cells between 1 and 2-3 weeks postoperatively.     

异种脱细胞神经移植修复大鼠面神经缺损的实验研究

目的 探讨异种脱细胞神经桥接大鼠面神经缺损后的神经再生方式。方法 用脱细胞兔面神经作为移植物桥接大鼠面神经颊支2 cm缺损,以自体腓神经移植作为正常对照组。术后5周和12周,取面神经移植段中部及远端吻合口处各3mm神经组织,进行组织学检测。结果 12周时,两组中移植段分叉处远端均有再生纤维,再生纤维数在两组之间无显著性差异。结论 异种脱细胞神经作为神经再生通道,其再生能力与自体神经无显著差异,可以作为自体神经移植的可选替代物。