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At least 217 records · Page 12Linked to original sources
PubMed1996

Role of a muscle target organ on the regeneration of motor nerve fibres in long nerve grafts: a synopsis of experimental and clinical data.

The importance of the muscle target organ as a promoting factor for nerve fibre regeneration in nerve grafts is still a subject of controversial discussion. In the last few years we published uniform results of experimental series in sheep and rabbits in which we investigated the biology of nerve fibre regeneration in long nerve autografts without connection to a target organ. Surprisingly, we found excellent regeneration of myelinated nerve fibres without the influence of a target organ through the whole length of the nerve graft, with an increase in the number of nerve fibres up to fourfold at the distal end. In the sheep series the additional contact with a muscle target organ for 6 months had a variable effect on the fibre population in the distal end of the nerve graft. The results of our planimetric analyses of nerve biopsies in patients with facial paralysis, who were treated by cross-face nerve grafting and free muscle transplantation, are extremely divergent from the results of our experimental series. Instead of an increase, we found a decrease in number of regenerating nerve fibres arriving at the distal end of the cross-face nerve graft down to 20%. Species-specific differences in the biology of nerve regeneration are discussed, together with their implications for the complex clinical situation of nerve grafting with or without the influence of a target organ.

Anastomosis, Surgical↗
PubMed2001

Nerve regeneration through an epineurial sheath: its functional aspect compared with nerve and vein grafts.

Although nerve graft is still the only reliable choice in repair of defects in peripheral nerve structure, it has the disadvantage of donor nerve morbidity and of sometimes being unavailable. It has long been researched in alternate nerve grafts with other materials. Studies have shown that nerves could regenerate across short nerve gaps through various conduits, such as veins, pseudosheaths, and bioabsorbable tubes. Despite encouraging studies, their functional results remain unclear. The present study used 40 rats, in which nerve grafts, vein grafts, and epineurial tubes were placed into 1-cm gaps in sciatic nerves created by resection. In one group, sciatic nerves were denuded of the surrounding epineurium, to assess the possible morbidity caused by epineurial sheath technique. At 2, 4, 8, 12, 20, and 28 weeks, functional assessment of nerve regeneration was performed using walking track analysis. The number of myelinated fibers and fiber diameters was measured and electron microscopic evaluation performed. Functionally, the index values were very close to each other in nerve graft and epineurial sheath groups. Morphometric analysis showed significance between the groups. The result of denuded sciatic nerve group was the same as the base track values. It was concluded that the ready availability of epineurial sheath as a conduit to span short nerve gaps could eliminate the morbidity associated with nerve graft harvest and capitalize on the potential benefits of neurotrophism in directing nerve regeneration.

Animals↗