兔耳大神经植入颈部皮瓣修复颊缺损重建感觉的实验研究

目的客观评价兔耳大神经植入颈部带蒂皮瓣修复颊缺损感觉恢复效果。方法选用日本大耳白兔15只,体重2.0-2.5kg,雌雄不限分为实验组（神经植入组）、对照组（未植入神经组）、正常组（未作任何处理）,每组各5只。在实验组与对照组兔左颊制备2.0cm×2.0cm圆形皮肤缺损,在颈部制备带蒂皮瓣4.5cm×2.5cm修复缺损,实验组植入耳大神经,对照组不植入,正常组不作任何处理。6个月后用神经单纤维放电技术、HE染色及S-100单克隆抗体免疫组织化学染色技术分析兔耳大神经植入皮瓣后神经纤维再生情况。结果实验组皮瓣放电神经纤维数（124.2±33.8条）及各类纤维比例与正常组（138.4±20.4条）无统计学差异（P〉0.05）,与对照组（18.8±5.6条）比较差异有统计学意义（P〈0.05）,其皮瓣中央区神经纤维放电率感受野分布与耳大神经植入的路径一致;组织学及免疫组织化学染色观察,可见皮瓣中央区真皮下有大量再生神经纤维,接近正常组水平。对照组未见再生神经纤维。结论耳大神经植入皮瓣可再生神经纤维,感觉功能恢复较好。

REESTABLISHMENT OF SENSORY FUNCTION AFTER GREATER AURICULAR NERVE IMPLANTED INTO FLAP FOR RECONSTRUCTION OF BUCCAL DEFECT IN RABBITS

OBJECTIVE: To assess the sensory restoration after the greater auricular nerve is implanted into the flap to repair the buccal defect in rabbits. METHODS: Fifteen Japanese white rabbits, weighing 2.0-2.5 kg, were randomly divided into the experimental group (nerve implanted), the control group (nerve unimplanted), and the normal group (without any treatment). In the experimental and the control group, circular defects (2.0 cm x 2.0 cm) were constructed in the left cheek of the rabbits. Then, the cervical flaps (4.5 cm x 2.5 cm) were transferred and the great auricular nerve was implanted into the defects in the experimental group, and the flaps without any nerve were implanted into the defects in the control group. The subjects in the normal group were given no treatment. After 6 months, the nerve discharge, the HE staining, and the immunohistochemical method were used to assess the regeneration of the nerve fibers. RESULTS: The nerve discharge and the percentage of the different kinds of the nerve fibers in the experimental group (124.2 +/- 33.8 roots) were not statistically different from those in the normal group (138.4+/-20.4 roots, P>0.05), but significantly different from those in the control group (18.8+/-5.6 roots, P<0.05). In the center of the flap in the experimental group, the receptive field of the nerve fibers was identical to the implanting approach of the greater auricular nerve. The HE staining and the immunohistochemical staining showed that the density of the regenerated fibers in the center of the flap in the experimental group reached the normal level. There was no regenerated fibers in the control group. CONCLUSION: The great auricular nerve implanted into the cervical flaps has a good effect on reconstruction of the buccal defect in rabbits.