ABSTRACT
In this study, we aimed to develop a new muscular neurotization technique, in which
transection of the donor nerve is avoided. We investigated the outcome of insertion
of the donor nerve within the denervated muscle following segmentary epineurectomy
(lateral muscular neurotization). Thirty-five male Wistar rats were evaluated in five
groups, including sham control, denervation control, denervation combined with segmentary
epineurectomy, direct muscular neurotization, and lateral muscular neurotization.
Electromyography, muscle weight measurements, and histological evaluations were performed
at postoperative months 2 and 3. The denervation group was statistically successful
for denervation as compared with the sham control group for all parameters. The lateral
neurotization group was successful in preventing muscle atrophy and gaining reinnervation
in electromyographic, histological, and weight parameters. The direct neurotization
group was also successful in histological and weight parameters. Lateral muscular
neurotization is promising because it does not interrupt the fascicular integrity
and is successful in reinnervation; therefore, it seems to be a good alternative for
direct muscular neurotization.
KEYWORDS
Muscular neurotization - implantation - lateral neurotization - muscle reinnervation
REFERENCES
- 1 Guyton C A, Hall J E. Medical Physiology. 10th ed. Philadelphia; WB Saunders Company
2001: 78-79
- 2
Engel A G.
Trophic functions of the neuron. II. Denervation and regulation of muscle. Morphological
effects of denervation of muscle. A quantitative ultrastructural study.
Ann N Y Acad Sci.
1974;
228
68-88
- 3
Harii K, Ohmori K, Torii S.
Free gracilis muscle transplantation with microneurovascular anastomoses for the treatment
of facial paralysis: a preliminary report.
Plast Reconstr Surg.
1976;
57
133-143
- 4
Tamai S, Komatsu S, Sakamoto H et al..
Free muscle transplants in dogs, with microsurgical neurovascular anastomoses.
Plast Reconstr Surg.
1970;
46
219-225
- 5
Erlacher P.
Direct and muscular neurotization of muscles: experimental research.
Am J Orthop Surg.
1915;
13
22-32
- 6
Sorbie C, Porter T L.
Reinnervation of paralyzed muscles by direct motor nerve implantation. An experimental
study in the dog.
J Bone Joint Surg Br.
1969;
51
156-164
- 7
Brunelli G A, Brunelli G R.
Direct muscle neurotization.
J Reconstr Microsurg.
1993;
9
81-90
- 8
Rubin L R, McCoy W.
Neural neurotization.
Ann Plast Surg.
1978;
1
562-567
- 9
Steindler A.
Direct neurotization of paralyzed muscles: further studies of the question of direct
implantation.
Am J Orthop Surg.
1916;
14
707-719
- 10
Mackinnon S E, McLean J A, Hunter G A.
Direct muscle neurotization recovers gastrocnemius muscle function.
J Reconstr Microsurg.
1993;
9
77-80
- 11
McNamara M J, Garrett W E, Seaber A V et al..
Neurorraphy, nerve grafting and neurotization: a functional comparison of nerve reconstruction
techniques.
J Hand Surg [Am].
1987;
12
354-360
- 12
Liu J, Kumar V P, Shen Y et al..
Modifier Sihler's technique for studying the distribution of intramuscular nerve branches
in mammalian skeletal muscle.
Anat Rec.
1997;
247
137-144
- 13
Meals R A, Nelissen R G.
The origin and meaning of “neurotization”.
J Hand Surg [Am].
1995;
20
144-146
- 14
Millesi H.
Peripheral nerve repair: terminology, questions and facts.
J Reconstr Microsurg.
1985;
2
21-31
- 15
Elsberg C A.
Experiments on motor nerve regeneration and the direct neurotization of paralyzed
muscles by their own and foreign nerves.
Science.
1917;
45
318-320
- 16
Mackinnon S E.
New directions in peripheral nerve surgery.
Ann Plast Surg.
1989;
22
257-273
- 17
Steindler A.
The method of direct neurotization of paralyzed muscles.
Am J Orthop Surg.
1915;
13
33-45
- 18
Sakellarides H T, Sorbie C, James L.
Reinnervation of denervated muscles by nerve transplantation.
Clin Orthop Relat Res.
1972;
83
195-201
- 19
Park D M, Shon S K, Kim Y J.
Direct muscle neurotization in rat soleus muscle.
J Reconstr Microsurg.
2000;
16
135-140
- 20
Aitken J T.
Growth of nerve implants in voluntary muscle.
J Anat.
1950;
84
38-49
- 21
Aitken J T.
Problems of reinnervation of muscle.
Prog Brain Res.
1965;
14
232-259
- 22
Noah E M, Williams A, Fortes W et al..
A new animal model to investigate axonal sprouting after end-to-side neurorraphy.
J Reconstr Microsurg.
1997;
13
317-325
- 23
al-Qattan M M, al-Thunyan A.
Variables affecting axonal regeneration following end-to-side neurorraphy.
Br J Plast Surg.
1998;
51
238-242
- 24
Papalia I, Lacroix C, Brunelli F et al..
Direct muscle neurotization after end-to-side neurorrhaphy.
J Reconstr Microsurg.
2001;
17
237-246
Ilker YaziciM.D.
Askaabat Cad. Eser Sit. A-Blok No. 8, Bahçelievler
Ankara 06490, Turkey
Email: ilkeryazici@gmail.com