End-to-Side Nerve Grafts: Experimental Study in Rats

ABSTRACT

The effectiveness of the end-to-side nerve graft in comparison with the end-to-end cable-graft was determined in rat sciatic nerve transection models. Sixty Sprague-Dawley rats were randomly divided into four groups with different reconstructive methods for two branches of the sciatic nerve: Group I, median nerve graft with end-to-side neurorrhaphy; Group II, median and ulnar nerve grafts with end-to-end neurorrhaphy; Group III, no repair; and Group IV, sham operation. Between Groups I and II, there were no significant differences in the functional, electrophysiologic, and histologic evaluations. In retrograde tracing of the spinal cord and dorsal root ganglia, the number of double-labeled neurons was significantly higher in Group I. End-to-side nerve grafts show good functional recovery, require less graft, and are easy to perform. The authors find this method to be an effective alternative in facial nerve reconstruction and of great value in various kinds of peripheral nerve surgery.

End-to-side neurorrhaphy - nerve graft - multiple branch reconstruction

REFERENCES

• 1 Kennedy R. On the restoration of coordinated movement after nerve crossing, with intercharge of function of the cerebral cortical centers.  Phil Trans R Soc Lond [Biol]. 1901;  194B 127
• 2 Ballance C A, Ballance H A, Stewart P. Remarks on the operative treatment of chronic facial palsy of peripheral origin.  Br Med J. 1903;  1 1009
• 3 Viterbo F, Trindade 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
• 4 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. 1994;  19B 277-282
• 5 Kalliainen L K, Cederna P S, Kuzon Jr W M. Mechanical function of muscle reinnervated by end-to-side neurorrhaphy.  Plast Reconstr Surg. 1999;  103 1919-1927
• 6 Zhang Z, Soucacos P N, Bo J, Beris A E. Evaluation of collateral sprouting after end-to-side nerve coaptation using a fluorescent double-labeling technique.  Microsurgery. 1999;  19 281-286
• 7 Zhao J Z, Chen Z W, Chen T Y. Nerve regeneration after terminolateral neurorrhaphy: experimental study in rats.  J Reconstr Microsurg. 1997;  13 31-37
• 8 Cederna P S, Kalliainen L K, Urbanchek M G, Rovak J M, Kuzon Jr W M. “Donor” muscle structure and function after end-to-side neurorrhaphy.  Plast Reconstr Surg. 2001;  107 789-796
• 9 Xiong G, Ling L, Nakamura R, Sugiura Y. Retrograde tracing and electrophysiological findings of collateral sprouting after end-to-side neurorrhaphy.  Hand Surg. 2003;  8 145-150
• 10 Al-Qattan M M. Terminolateral neurorrhaphy: review of experimental and clinical studies.  J Reconstr Microsurg. 2001;  17 99-108
• 11 Kostakoglu N. Motor and sensory reinnervation in the hand after an end-to-side median to ulnar nerve coaptation in the forearm.  Br J Plast Surg. 1999;  52 404-407
• 12 Viterbo F, Franciosi L F, Palhares A. Nerve graftings and end-to-side neurorrhaphies connecting the phrenic nerve to the brachial plexus.  Plast Reconstr Surg. 1995;  96 494-495
• 13 Koh K S, Kim J K, Kim C J, Kwun B D, Kim S Y. Hypoglossal-facial crossover in facial-nerve palsy: pure end-to-side anastomosis technique.  Br J Plast Surg. 2002;  55 25-31
• 14 Jaberi F M, Abbas B P, Nezhad S T, Tanideh N. End-to-side neurorrhaphy: an experimental study in rabbits.  Microsurgery. 2003;  23 359-362
• 15 Ogun T C, Ozdemir M, Senaran H, Ustun M E. End-to-side neurorrhaphy as a salvage procedure for irreparable nerve injuries. Technical note.  J Neurosurg. 2003;  99 180-185
• 16 Mennen U, van der Westhuizen M J, Eggers I M. Re-innervation of M. biceps by end-to-side nerve suture.  Hand Surg. 2003;  8 25-31
• 17 Mennen U. End-to-side nerve suture in clinical practice.  Hand Surg. 2003;  8 33-42
• 18 Kakibuchi M, Tuji K, Fukuda K et al.. End-to-side nerve graft for facial nerve reconstruction.  Ann Plast Surg. 2004;  53 496-500
• 19 Lutz B S, Ma S F, Chuang D C, Chan K H, Wei F C. Interposition of a pedicle fat flap significantly improves specificity of reinnervation and motor recovery after repair of transected nerves in adjacency in rats.  Plast Reconstr Surg. 2001;  107 116-123
• 20 Ozmen S, Ayhan S, Latifoglu O, Siemionow M. Stamp and paper method: a superior technique for the walking track analysis.  Plast Reconstr Surg. 2002;  109 1760-1761
• 21 Bain J R, Mackinnon S E, Hunter D A. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat.  Plast Reconstr Surg. 1989;  83 129-138
• 22 Caplan J, Tiangco D A, Terzis J K. Effects of IGF-II in a new end-to-side model.  J Reconstr Microsurg. 1999;  15 351-358
• 23 Haase P, Payne J N. Comparison of the efficiencies of true blue and diamidino yellow as retrograde tracers in the peripheral motor system.  J Neurosci Methods. 1990;  35 175-183
• 24 Puigdellivol-Sanchez A, Valero-Cabre A, Prats-Galino A, Navarro X, Molander C. On the use of fast blue, fluoro-gold and diamidino yellow for retrograde tracing after peripheral nerve injury: uptake, fading, dye interactions, and toxicity.  J Neurosci Methods. 2002;  115 115-127
• 25 Tarasidis G, Watanabe O, Mackinnon S E, Strasberg S R, Haughey B H, Hunter D A. End-to-side neurorraphy: a long-term study of neural regeneration in a rat model.  Otolaryngol Head Neck Surg. 1998;  119 337-341
• 26 Matsumoto M, Hirata H, Nishiyama M, Morita A, Sasaki H, Uchida A. Schwann cells can induce collateral sprouting from intact axons: experimental study of end-to-side neurorrhaphy using a Y-chamber model.  J Reconstr Microsurg. 1999;  15 281-286
• 27 McCallister W V, Tang P, Trumble T E. Is end-to-side neurorrhaphy effective? A study of axonal sprouting stimulated from intact nerves.  J Reconstr Microsurg. 1999;  15 597-603 discussion 603-594