Terminolateral fiber count.
Plastic and reconstructive surgery (Impact Factor: 2.74). 11/2005; 116(5):1561-2; author reply 1562. DOI:10.1097/01.prs.0000184341.22692.8f
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ABSTRACT: Recent evidence supports the use of end-to-side neurorrhaphy for the treatment of certain peripheral nerve disorders. However, the mechanism by which nerves regenerate following this procedure is still unclear. To address this question, the authors designed a new end-to-side coaptation model in rats in which the donor nerves were uninjured. The regenerated axons at the coaptation site were observed directly using fluorescent dye as the neural tracer. The sciatic nerve from adult Wistar rats was transplanted between the left and right median nerves. Fifteen rats were divided into three groups. In group I, the donor (right median) nerve was sutured end to side to the divided grafted nerve using a noninjury technique. In group II, the aponeurosis of the spinal muscles was harvested and the sciatic and right median nerves were coapted end to side noninjuriously by wrapping them in the excised aponeurosis. In group III, a perineurial window was created and a partial neurectomy was carried out at the suture site, after which the sciatic and right median nerves were sutured end to side. Sixty days after the operation, nerve regeneration was evaluated by recording action potentials in the grafted nerve, by performing electromyography in the flexor muscles in the forearm, and by histological examination. The grafted nerves were fixed and sectioned, the number of regenerated nerve fibers was counted, and axonal diameters were measured. Fluorescent dye crystal was used, in conjunction with confocal microscopy, to observe the regenerated axons at the co-aptation site. The results showed that nerve regeneration had occurred in the animals, as determined electrophysiologically and histologically. Both the right and left flexor muscles of the forearm contracted simultaneously as a result of indirect electric stimulation of the grafted nerve, which suggests that the regenerated nerve was physiologically connected with the donor nerve. Nerve fiber counts did not show any differences among groups (p > 0.05), but axonal diameters were significantly greater in group III than in the other two groups. Fluorescent dye staining revealed the presence of regenerated nerve fibers beyond the coaptation site. In group III, the regenerating nerves were observed within the whole section of the coaptation site and collateral sprouting was found to occur even at a site distal to the suture. From these results, the authors conclude that in end-to-side neurorrhaphy, nerve regeneration occurs by collateral sprouting from the donor nerve.Plastic & Reconstructive Surgery 07/2004; 114(1):129-37. · 3.54 Impact Factor
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ABSTRACT: Four methods of nerve terminolateral neurorrhaphy (TLN) were studied in rat experimental model. In Group A, the distal end of a severed peroneal nerve was sutured end-to-side with an intact tibial nerve trunk, without removal of the tibial epineurium at the suture site. In Group B, the distal end of a severed peroneal nerve was sutured end-to-side with the intact tibial nerve trunk, with removal of the tibial epineurium at the suture site. In Group C, a nerve segment was bridged between the distal part of the severed peroneal nerve and the intact tibial nerve with two end-to-side sutures. In Group D, the proximal end of a severed tibial nerve was sutured end-to-side with the peroneal nerve trunk. Through electrophysiologic, histologic, and ultrastructural examinations, the following conclusions were drawn: 1. Nerve regeneration is possible after TLN. 2. The regenerating fibers after TLN have the ability to penetrate the endoneurium, perineurium, and epineurium. 3. After different methods of TLN, the regenerating fibers grow in both a flowing-out and a filling-in fashion.Journal of Reconstructive Microsurgery 02/1997; 13(1):31-7. · 1.00 Impact Factor
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