面神经在硅小室再生的研究

目的：观察硅小室技术对面神经损伤后神经修复形态学及再生过程的影响．方法：豚鼠面神经颊支缺损１０ｍｍ，用硅小室桥接．采用光镜、透射电镜、图象分析及ＨＲＰ逆行追踪法，观察面神经在硅小室内再生过程中的形态学改变与证实神经的再通．结果：面神经损伤后第１周，硅小室内神经远、近心端再生神经分别向内生长约２．４ｍｍ；第２周，两断端神经已再通，但较细；第１０周，神经接近正常．电镜显示第４周起，有髓纤维的雪旺细胞（ＳＣ）功能活跃，细胞内可见丰富的粗面内质网、线粒体等；第１０周，再生神经基本接近正常．伤后第１～７周，损伤神经与对照组间有髓纤维数、髓鞘面积、轴突面积、Ｇ率、有髓纤维面积百分含量比较，差异显著（Ｐ＜０．０１）．ＨＲＰ逆行追踪，第１０周时损伤神经再通，ＨＲＰ阳性标记细胞分布于面神经核团的外侧群、中间群、背外侧群．结论：通过硅小室桥接损伤神经，在无外源性生长因于作用下，其促神经再生作用是肯定的．缺损距离１０ｍｍ时，第１０周再生神经接近正常．

Research of the facial nerve regeneration in silicone chamber after injury

AIM: To observe the facial nerve morphology andthe course of regeneration after injury in silicone chamber.METHODS: The buccal branch of facial nerve with a gap of 10mm was bridged in silicone chamber. The light microscope.electron microscope, computerized image and HRP retrogradetracing were used for showing morphology of nerve regeneration and confirming the nervous regenertion succeeded. RESULTS: The distal and proximal transected neural stumps offacial nerve growth about 2. 4 mm at 1st wk, and at 2 nd wk itwas put through, at 10th wk it approach normal. Electronmicroscope observation at the 4 th wk, fibers myelin ofSchwann cell was in an active functional condition, there wererich rough endoplasmic reticulum in Schwann cells. At 10 thwk, the regenerated nerve were nearly normal. At the 1st to7 th wk after injury, there were significant difference in thenumber of myelinated a-cons, myelin sheath area, axon area,G rate, % of myelinated area between the injuried and normalnerve (P<0. 01 ). At the end of 10 th wk, HRP retrogradetracing of the regenerated nerve was passed through, labelledHRP cell were located in the lateral, medial and dorsalateralsubnucleus of facial nucleus. CONCLUSION :The role of pro-mote nerve regeneration in silicone chamber without exogenicgrowth factor were confirmed after the nerve injury. Nervewith a gap of 10 mm, regenerated nerve were nearly normalat 10 th wk.