自体变性骨骼肌对面神经缺损的修复(英文)

Repairing facial nerve defect with autologous degenerative skeletal muscle

背景:面神经缺损严重影响患者身心健康及生活质量,临床采用较多的有带蒂颈肌移植术和自体神经移植术等修复面神经缺损,恢复面肌的功能,但上述方法均有其缺点和局限性,使其广泛应用受到限制,寻求一种新的修复面神经缺损的材料是目前研究的热点。目的:探讨自体变性骨骼肌替代神经材料对面神经缺损的修复作用,为进一步提高面神经功能提供理论依据。设计:以动物为研究对象,随机对照的实验研究。单位:一所医学院的解剖学教研室和神经科。材料:实验于2002-04/09在咸宁医学院神经组化研究室进行。选择日本大耳白兔22只,随机分为3组:A组8只以自体变性骨骼肌移植修复,B组8只以自体神经移植修复,C组6只作为正常对照。方法:22只日本大耳白兔左侧面神经上颊支缺损8mm为模型,术后20周分别对各组实验动物的上颊支神经(含移植体)及其支配的面肌进行电生理学检测及形态学图像观测。主要观察指标:各组电生理检测结果和形态学观察。结果:电生理学检测:在神经干动作电位,面肌复合动作电位,神经传导速度3项对应指标的组间比较,A组和B组比较,差异无显著性意义(P>0.05),而A,B组与C组比较差异有显著性(P<0.05)。形态学图像分析:神经纤维数:A组(2559±1683)条,B组(2658±1295)条,C组(3253±1564)条;神经纤维直径:A组(4.01±0.88)

BACKGROUND:Facial nerve defect seriously impacts the mental and physical health of patients as well as their quality of life. Pediceled neck muscle transplant and autologous nerve transplant have been used in clinical to repair facial nerve defect and restore the facial muscle function.However,there are disadvantages and limits of above methods which have restricted their wide application of them.It is a research hotspot for looking for a new material to repair facial nerve defect. OBJECTIVE:To investigate the effects of autologous degenerative skeletal muscle to repair facial nerve defect and provide theoretic basis for further improving the functions of facial nerve. DESIGN:Randomized controlled study based on animals. SETTING:Anatomy department and neurological department in a medical college. MATERIALS:The experiment was completed in the Neuro histochemical Teaching Section of Xianning Medical College from April to September 2002.Twenty two Japanese big ear rabbits were randomly divided into 3 groups:8 in group A to conduct autologous degenerative skeletal muscle transplant,8 in group B to conduct autologous nerve transplant and 6 in group C as normal control. METHODS:Animal model was built by make 8 mm defect of zygomatic branch of left facial nerve in 22 rabbits.Electrophysiological examination and morphologic observation were conducted to the zygomatic branch of facial nerve and the muscle it controlled to rabbits after 20 weeks. MAIN OUTCOME MEASURES:Electrophysiological examination results and morphologic observation of each group. RESULTS:Electrophysiological examination: Neural stem action potential(NAP),compound facial muscles action potential(cMAP) and nerve conduction velocity(NCV) were compared between groups.There was no difference between group A and B(P >0.05) while significant difference existed between group A and C,B and C (P< 0.05).Morphological image analysis:number of nerve fibers was 2 559±1 683 in group A,2 658±1 295 in group B and 3 253±1 564 in group C.Diameter of nerve fiber was(4.01±0.88) μm,(4.26±0.77) μm,(4.98±0.72) μm for the three groups,respectively. Average density of regenerated nerve fiber:was(220±30) /0.013 89 mm2, (233±32) /0.0138 9 mm2,(315±27)/0.013 89 mm2,respectively.When comparing the above parameters between groups,there was no difference between group A and B(P >0.05),while there was significant difference between group A and C, B and C(P< 0.05). CONCLUSION:Autologous degenerative skeletal muscle can effectively induce and stimulate the regeneration of nerve and repair the facial nerve defect with the equivalent effects of autologous nerve transplant.