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J Reconstr Microsurg 2003; 19(5): 331-340
DOI: 10.1055/s-2003-42502
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Histologic Analysis of Schwann Cell Migration and Peripheral Nerve Regeneration in the Autogenous Venous Nerve Conduit (AVNC)

Charles Y. Tseng1,2,3 , GuoLi Hu3 , Richard T. Ambron3 , David T.W. Chiu1,2,3,4
  • 1Center for Restorative Surgery, College of Physicians and Surgeons, Columbia University, New York, NY
  • 2Department of Otolaryngology, College of Physicians and Surgeons, Columbia University, New York, NY
  • 3Department of Anatomy and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY
  • 4Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY
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Publication History

Publication Date:
24 September 2003 (online)

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ABSTRACT

Over the last two decades, the autogenous venous nerve conduit (AVNC) has been established as an effective treatment modality for the repair of nerve gaps less than 3 cm. In this study, the spatial-temporal progression of Schwann-cell migration and peripheral-nerve regeneration across a 10-mm gap bridged by a venous conduit was examined, using immunoctyochemical techniques. Histologic analysis revealed that the process of nerve regeneration through an AVNC occurs in four phases: the hematoma phase, cellular migration phase, axonal advancement phase, and myelination and maturation phase. The authors found that: 1) the lumen of the vein conduit remains patent throughout the process of nerve regeneration; 2) Schwann cells migrate into the vital space of the vessel lumen from the proximal and distal nerve stumps; 3) axonal growth into the conduit lags behind Schwann-cell migration; 4) Schwann cells migrate to the regenerating axons to form mature nodes of Ranvier when the distal stump is present; and 5) mechanical injury alone is sufficient to induce axonal outgrowth from the proximal nerve stump.

KEYWORDS

Vein conduit - nerve regeneration - Schwann cells

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