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DOI: 10.1055/s-0028-1088229
Muscle Flap Mass Preservation by Sensory Reinnervation with End-to-Side Neurorrhaphy: An Experimental Study in Rats
Publication History
Publication Date:
16 September 2008 (online)
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ABSTRACT
The purpose of this study was to determine whether sensory reinnervation with end-to-side neurorrhaphy preserves muscle mass in pedicled muscle flaps. A new muscle flap model innervated by the common peroneal nerve (CPN) was tested in rats. Animals were divided into group 1 (CPN transected without repair), group 2 (CPN transected and immediately repaired by end-to-end neurorrhaphy), and groups 3A and 3B (CPN transected and repaired with the sural nerve, by end-to-end and end-to-side neurorrhaphy, respectively). We evaluated the muscle-preserving effect by measuring muscle weight and performed histological and morphometric analyses 3 months after the procedure. Sensory reinnervation significantly preserved the muscle mass, although less than motor reinnervation. There was no significant difference between the end-to-end and end-to-side procedures. Results of morphometric analysis in each group paralleled those of mean muscle weight. Sensory reinnervation with end-to-side neurorrhaphy appears to be useful in the preservation of muscle flap mass.
KEYWORDS
End-to-side neurorrhaphy - sensory reinnervation - minimizing muscle flap atrophy
REFERENCES
- 1 Hie H B, van Nie C J, Vermeulen-van der Zee E. Twitch tension, muscle weight and fiber area of exercised reinnervating rat skeletal muscle. Arch Phys Med Rehabil. 1982; 63 608-612
- 2 Helgren M E, Squinto S P, Davis H L et al.. Trophic effect of ciliary neurotrophic factor on denervated skeletal muscle. Cell. 1994; 76 493-504
- 3 Chang K N, DeArmond S J, Buncke Jr H J. Sensory reinnervation in microsurgical reconstruction of the heel. Plast Reconstr Surg. 1986; 78 652-664
- 4 Hynes N M, Bain J R, Thoma A, Veltri K, Maguire J A. Preservation of denervated muscle by sensory protection in rats. J Reconstr Microsurg. 1997; 13 337-343
- 5 Papakonstantinou K C, Kamin E, Terzis J K. Muscle preservation by prolonged sensory protection. J Reconstr Microsurg. 2002; 18 173-184
- 6 Wang H, Gu Y, Xu J, Shen L, Li J. Comparative study of different surgical procedures using sensory nerves or neurons for delaying atrophy of denervated skeletal muscle. J Hand Surg [Am]. 2001; 26 326-331
-
7 Dautel G, Lineaweaver W, Campagne-Pinto D et al..
Preservation of transplanted muscle mass by motor and sensory reinnervation . In: Freilinger G, Deutinger M Transactions of the Third Vienna Muscle Symposium. Vienna; Blackwell-MZV 1992: 96-98 - 8 Zhang F, Lineaweaver W C, Üstüner T et al.. Comparison of muscle mass preservation in denervated muscle and transplanted muscle flaps after motor and sensory reinnervation and neurotization. Plast Reconstr Surg. 1997; 99 803-814
- 9 Dedkov E I, Borisov A B, Carlson B M. Dynamics of postdenervation atrophy young and old skeletal muscles: differential responses of fiber types and muscle types. J Gerontol A Biol Sci Med Sci. 2003; 58 984-991
- 10 Kanaya F. An experimental study on denervated muscle atrophy: effect of electrostimulation and comparison with immobilization muscle atrophy. Nippon Seikeigeka Gakkai Zasshi. 1988; 62 635-651
- 11 Oswald T M, Zhang F, Lei M P, Gerzenshtein J, Lineaweaver W C. Muscle flap mass preservation with end-to-side neurorrhaphy: an experimental study. J Reconstr Microsurg. 2004; 20 483-488
- 12 Matsuda H, Hata Y, Matsuka K, Ito O, Battal N M. Experimental study of nerve regeneration in end-to-side nerve coaptation. J Jpn PRS. 1995; 15 910-918
- 13 Viterbo F, Trindade J C, Hoshino K, Mazzoni Neto A. Lateral-terminal neurorrhaphy without removal of epineural sheath. Experimental study in rats. Rev Paul Med. 1992; 110 267-275
- 14 Viterbo F, Trindate J C, Hoshino K, Mazzoni Neto A. End-to-side neurorrhaphy with removal of the epineurial sheath: an experimental study in rats. Plast Reconstr Surg. 1994; 94 1038-1047
- 15 Viterbo F, Trindate J C, Hoshino K, Mazzoni A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats. Br J Plast Surg. 1994; 47 75-80
- 16 Lundborg G, Zhao Q, Kanje M, Danielsen N, Kerns J M. Can sensory and motor collateral sprouting be induced from intact peripheral nerve by end-to-side anastomosis?. J Hand Surg [Br]. 1994; 19 277-282
- 17 Bertelli J A, dos Santos A R, Calixto J B. Is axonal sprouting able to traverse the conjunctival layers of the peripheral nerve? A behavioral, motor, and sensory study of end-to-side nerve anastomosis. J Reconstr Microsurg. 1996; 12 559-563
- 18 Tarasidis G, Watanabe O, Mackinnon S E, Strasberg S R, Haughey B H, Hunter D A. End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model. Ann Otol Rhinol Laryngol. 1997; 106 506-512
- 19 Schaafsma A, Otten E, Van Willigen J D. A muscle spindle model for primary afferent firing based on a simulation of intrafusal mechanical events. J Neurophysiol. 1991; 65 1297-1312
- 20 Yin Q, Kemp G J, Frostick S P. Neurotrophins, neurons and peripheral nerve regeneration. J Hand Surg [Br]. 1998; 23 433-437
- 21 Terenghi G. Peripheral nerve regeneration and neurotrophic factors. J Anat. 1999; 194 1-14
- 22 Love F M, Thompson W J. Schwann cells proliferate at rat neuromuscular junctions during development and regeneration. J Neurosci. 1988; 18 9376-9385
- 23 Tonra J R, Curtis R, Wong V et al.. Axonotomy upregulates the antegrade transport and expression of brain-derived neurotrophic factor in sensory neurons. J Neurosci. 1998; 18 4374-4383
- 24 Falempin M, Ternaux J, Palouzier B, Chamoin M C. Presence of cholinergic neurons in the vagal afferent system: involvement in a heterogeneous reinnervation. J Auton Nerv Syst. 1989; 28 243-250
- 25 Zalewski A A. Effects of reinnervation on denervated skeletal muscle by axons of motor, sensory and sympathetic neurons. Am J Physiol. 1970; 219 1675-1679
Sumiko YoshitatsuM.D.
Department of Plastic Surgery, Osaka National Hospital, 2-1-14
Houenzaka, Chuou-Ku, Osaka city, Osaka, Japan, 540-0006
Email: syoshi@onh.go.jp