Facial nerve repair: Fibrin Adhesive Coaptation versus Epineurial Suture Repair in a Rodent Model.
ABSTRACT OBJECTIVES/HYPOTHESIS: Repair of the transected facial nerve has traditionally been accomplished with microsurgical neurorrhaphy; however, fibrin adhesive coaptation (FAC) of peripheral nerves has become increasingly popular over the past decade. We compared functional recovery following suture neurorrhaphy to FAC in a rodent facial nerve model. STUDY DESIGN: Prospective, randomized animal study. METHODS: Sixteen rats underwent transection and repair of the facial nerve proximal to the pes anserinus. Eight animals underwent epineurial suture (ES) neurorrhaphy, and eight underwent repair with fibrin adhesive (FA). Surgical times were documented for all procedures. Whisking function was analyzed on a weekly basis for both groups across 15 weeks of recovery. RESULTS: Rats experienced whisking recovery consistent in time course and degree with prior studies of rodent facial nerve transection and repair. There were no significant differences in whisking amplitude, velocity, or acceleration between suture and FA groups. However, the neurorrhaphy time with FA was 70% shorter than for ES (P < 0.05). CONCLUSION: Although we found no difference in whisking recovery between suture and FA repair of the main trunk of the rat facial nerve, the significantly shorter operative time for FA repair makes this technique an attractive option. The relative advantages of both techniques are discussed.
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ABSTRACT: Introduction: Fibrin sealants (FS) have been approved for use in the United States since 1998. Since approval, they have been used in a wide variety of clinical settings and new products continue to be introduced. Areas covered: This review covers the literature supporting the USA FDA-approved indications for FS products produced by Baxter Corp. Literature review of PubMed, the Cochrane Library, FDA approval documents and product websites yielded information contained in this article. Mechanism of action, efficacy and safety of these products are covered. Expert opinion: FS are generally safe, popular and are used for a wide variety of off-label indications. Their use appears to be expanding rapidly. For many uses, including approved ones, large well-controlled trials are still needed. Additionally, cost-effectiveness data for these products would be a great benefit in guiding their future use.Expert opinion on biological therapy 03/2014; · 3.22 Impact Factor
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ABSTRACT: Per-clinical studies using animal models play a very important role in the evaluation of facial nerve regeneration. Good models need to recapitulate the distance and time for axons to regenerate in humans. Compared with the mostly used rodent animals, the structure of facial nerve in mini- pigs share more similarities with humans in microanatomy. To evaluate the feasibility of repairing facial nerve defects by collagen scaffolds combined with ciliaryneurotrophic factor (CNTF), 10mm-long-gaps were made in the buccal branch of mini-pigs’ facial nerve. Three months after surgery, electrophysiological assessment and histological examination were performedto evaluate facial nerveregeneration. Immunohistochemistry and transmission electron microscope observation showed that collagen scaffolds with CBD-CNTF could promote better axon regeneration, Schwann cell migration and remyelination at the site of implant device than using scaffolds alone. Electrophysiological assessment also showed higher recovery rate in the CNTF group. In summary, combination of collagen scaffolds and CBD-CNTF showed promising effects on facial nerve regeneration in mini- pig models.Journal of Biomedical Materials Research Part A 08/2014; · 2.83 Impact Factor