Manual stimulation of facial muscles improves functional recovery after hypoglossal–facial anastomosis and interpositional nerve grafting of the facial nerve in adult rats

AbstractRecently, we devised and validated a novel strategy in rats to improve the outcome of facial nerve reconstruction by daily manual stimulation of the target muscles. The treatment resulted in full recovery of facial movements (whisking), which was achieved by reducing the proportion of pathologically polyinnervated motor endplates. Here, we posed whether manual stimulation could also be beneficial after a surgical procedure potentially useful for treatment of large peripheral nerve defects, i.e., entubulation of the transected facial nerve in a conduit filled with suspension of isogeneic bone marrow-derived mesenchymal stem cells (BM-MSCs) in collagen. Compared to control treatment with collagen only, entubulation with BM-MSCs failed to decrease the extent of collateral axonal branching at the lesion site and did not improve functional recovery. Post-operative manual stimulation of vibrissal muscles also failed to promote a better recovery following entubulation with BM-MSCs. We suggest that BM-MSCs promote excessive trophic support for regenerating axons which, in turn, results in excessive collateral branching at the lesion site and extensive polyinnervation of the motor endplates. Furthermore, such deleterious effects cannot be overridden by manual stimulation. We conclude that entubulation with BM-MSCs is not beneficial for facial nerve repair.

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Intraoperative Monitoring of Facial Muscle Evoked Responses Obtained by Intracranial Stimulation of the Facial Nerve

Neurosurgery ◽

10.1227/00006123-197905000-00007 ◽

1979 ◽

Vol 4 (5) ◽

pp. 418-421 ◽

Cited By ~ 136

Author(s):

Tomas E. Delgado ◽

William A. Buchheit ◽

Henry R. Rosenholtz ◽

Shavarash Chrissian

Keyword(s):

Facial Nerve ◽

Intraoperative Monitoring ◽

Intracranial Stimulation ◽

Evoked Responses ◽

Facial Muscle ◽

Facial Muscles ◽

Acoustic Neuromas ◽

Suboccipital Approach ◽

Stimulation Of

abstract Total microsurgical removal of 14 acoustic neuromas greater than 2 cm in diameter was performed through a unilateral suboccipital approach. Precise quantitative intracranial stimulation of the 7th nerve and recording of the evoked responses of the facial muscles were used to improve the identification and facilitate the dissection of the facial nerve. Preoperative evaluations, techniques, and results are discussed.

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Rekonstruktivna hirurgija povreda facijalisa

Acta chirurgica iugoslavica ◽

10.2298/aci0301063b ◽

2003 ◽

Vol 50 (1) ◽

pp. 63-67

Author(s):

Vladimir Bascarevic ◽

Miroslav Samardzic ◽

Lukas Rasulic ◽

Vesna Simic

Keyword(s):

Facial Nerve ◽

Skull Base ◽

Surgical Procedures ◽

Functional Recovery ◽

Cerebellopontine Angle ◽

Motor Nerve ◽

Nerve Grafting ◽

Cerebellopontine Angle Tumors ◽

The Face ◽

Nerve Anastomosis

The facial nerve is main motor nerve of the face and its injury leads to total ipsilateral paralysis. There are several surgical procedures in reconstruction of the facial nerve, and the most frequent one is hypoglosso-facial anastomosis. In this study were analysed a series of 69 patients operated on Institute of neurosurgery from 1981 to 2000 year. The most frequent cause of injury was the operation of cerebellopontine angle tumors, as well as the skull base fractures. Hypoglosso-facial anastomosis was done in 57 patients, in 5 cases we performed nerve grafting in the cerebellopontine angle, and in 7 patients the facial nerve was operated peripherally. Results were analyzed in 27 of 57 patients with hipoglosso-facial nerve anastomosis. Functional recovery was achived in 22 (81,4%) patients.

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Recovery of whisking function promoted by manual stimulation of the vibrissal muscles after facial nerve injury requires insulin-like growth factor 1 (IGF-1)

Experimental Neurology ◽

10.1016/j.expneurol.2009.12.031 ◽

2010 ◽

Vol 222 (2) ◽

pp. 226-234 ◽

Cited By ~ 22

Author(s):

S. Kiryakova ◽

J. Söhnchen ◽

M. Grosheva ◽

U. Schuetz ◽

Ts. Marinova ◽

...

Keyword(s):

Growth Factor ◽

Facial Nerve ◽

Nerve Injury ◽

Insulin Like Growth Factor ◽

Facial Nerve Injury ◽

Manual Stimulation ◽

Stimulation Of

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Manual stimulation, but not acute electrical stimulation prior to reconstructive surgery, improves functional recovery after facial nerve injury in rats

Restorative Neurology and Neuroscience ◽

10.3233/rnn-2009-0474 ◽

2009 ◽

Vol 27 (3) ◽

pp. 237-251 ◽

Cited By ~ 2

Author(s):

Emmanouil Skouras ◽

Daniel Merkel ◽

Maria Grosheva ◽

Srebrina K. Angelova ◽

Gereon Schiffer ◽

...

Keyword(s):

Electrical Stimulation ◽

Facial Nerve ◽

Nerve Injury ◽

Functional Recovery ◽

Reconstructive Surgery ◽

Facial Nerve Injury ◽

Manual Stimulation

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IMPACT OF DIFFERENT TYPES OF FACIAL NERVE RECONSTRUCTION ON THE RECOVERY OF MOTOR FUNCTION

Neurosurgery ◽

10.1227/01.neu.0000306107.70421.a4 ◽

2007 ◽

Vol 61 (6) ◽

pp. 1276-1285 ◽

Cited By ~ 17

Author(s):

Orlando Guntinas-Lichius ◽

Gregor Hundeshagen ◽

Thomas Paling ◽

Doychin N. Angelov

Keyword(s):

Facial Nerve ◽

Functional Recovery ◽

Nerve Repair ◽

Angular Acceleration ◽

Full Recovery ◽

Fluorescence Labeling ◽

Nerve Reconstruction ◽

Adult Rats ◽

Facial Nerve Reconstruction ◽

Levator Labii Superioris

Abstract OBJECTIVE Poor functional recovery after facial nerve reconstruction is characterized by mass movements and synkinesis. Major reasons are axonal sprouting from the regenerating axons leading to misdirected reinnervation and hyperinnervation as well as polyinnervation of the mimic muscle end plates. We analyzed whether or not the type of nerve reconstruction influenced these pathological phenomena. METHODS The experiments were performed on 48 adult rats divided into four groups. One group served as an intact control and the experimental groups were subjected to facial-facial nerve repair (FFN), facial nerve interpositional grafting, and hypoglossal-facial nerve repair (HFN), with 12 subjects in each group. Two months later, functional recovery was measured by biometrical motion analysis of whisking. Retrograde fluorescence labeling of the brainstem motoneurons was used to quantify the degree of collateral axonal branching at the lesion site. Fluorescence histochemistry of sections through the levator labii superioris muscle was performed to quantify the degree of polyinnervation after surgery. RESULTS The type of nerve reconstruction significantly influenced the regeneration. The whisking amplitude did not recover completely regardless of the type of reconstruction. The angular velocity and angular acceleration of the vibrissal hairs showed a full recovery after facial nerve interpositional grafting and HFN, whereas these parameters remained decreased after FFN. Significantly less collateral branching and polyinnervation of the end plates were determined after grafting and HFN than after FFN. CONCLUSION No type of immediate facial nerve reconstruction results in a full recovery in the rat. However, the morphological and functional recovery was significantly better after grafting and HFN than after FFN.

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