体外培养诱导外周血单核细胞及淋巴细胞促进大鼠面神经再生的实验研究

目的通过在神经缺损处局部分别回输体外分离培养扩增的单核细胞和淋巴细胞,对比这两种细胞回输后促进受损面神经再生的效果。方法将30只Wistar大鼠分成3组,每组10只,分别为单核细胞组、淋巴细胞组、对照组,每组再分成2w和8w观察组。单核细胞组局部回输体外分离培养的外周血单核细胞,淋巴细胞组局部回输体外分离培养的外周血淋巴细胞,对照组回输等量的RPMI培养液。于2w和8w时测定面神经颊支-触须肌复合动作电位传导速度及辣根过氧化物酶(horseradish peroxidase,HRP)神经逆行示踪显示面神经核团的阳性神经元数目。结果2w时单核细胞回输组与淋巴细胞回输组面神经-触须肌的复合动作电位传导速度同术前的比值分别为0.64±0.12、0.35±0.15,8w时其比值分别为0.73±0.13、0.64±0.07。而2w时单核细胞回输组与淋巴细胞回输组HRP神经逆行示踪测定面神经核团阳性神经元数目分别为87.40±77.39、55.40±28.66个,8w时为528.40±63.33、541.40±55.67个。结论局部应用体外分离培养扩增的单核细胞对神经再生修复有一定的促进作用,其作用优于淋巴细胞。     

睫状神经营养因子对面神经损伤的修复作用

目的探讨局部应用睫状神经营养因子对面神经损伤的修复作用。方法将成年新西兰兔面神经上颊支切除5mm,在断端间置入硅胶再生室,实验组室内注入睫状神经营养因子,对照组用生理盐水。术后4周和8周进行电生理学、组织病理学观察和形态学定量分析。结果术后4周,两组电刺激面神经很少能引发面肌兴奋,有髓轴索计数,轴索直径和面积t检验,两组差异有显著性意义(P<0.05)。术后8周面神经复合肌动作电位,实验组运动神经传导速度明显短于对照组,有髓轴索计数,轴索直径和面积实验组大于对照组(P<0.05)。结论局部应用睫状神经营养因子可促进面神经损伤的修复。     

大鼠面神经核运动神经元的分布及神经损伤再支配后的变化

目的 研究正常和面神经损伤后再支配条件下大鼠面神经不同分支神经元的分布。方法 采用荧光素逆行双标法观察正常情况下面神经颊支和下颌缘支神经元的分布，以及神经损伤发生再支配后二者分布方式的变化。结果 正常情况下，发出颊支的神经元与发出下颌缘支的神经元位于面神经核中间内侧和外侧亚核，呈完全交迭分布；两种神经元排列紧密，但未见双标记神经元。面神经切断吻合后4个月，颊支神经元与下颌缘支神经元仍主要呈交迭分布，但标记的神经元数明显减少，神经元排列松散，部分颊支和下颌缘支神经元分布到背侧、腹内侧和内侧亚核。面神经切断吻合后6个月，颊支神经元与下颌缘支的分布方式与面神经吻合后4个月基本相同，但标记的神经元数明显增多，并见1%-2%的双标记神经元。结论 正常情况下面神经核内颊支神经元与下颌缘支神经元分布方式提示在颊支和下颌缘支的远端可能存在广泛的交通；神经损伤发生再支配后分布方式的变化则提示不同分支的运动神经元间存在错向再生。     

大鼠面神经核运动神经元的分布及神经损伤再支配后的变化

目的　研究正常和面神经损伤后再支配条件下大鼠面神经不同分支神经元的分布。方法　采用荧光素逆行双标法观察正常情况下面神经颊支和下颌缘支神经元的分布 ,以及神经损伤发生再支配后二者分布方式的变化。结果　正常情况下 ,发出颊支的神经元与发出下颌缘支的神经元位于面神经核中间内侧和外侧亚核 ,呈完全交迭分布 ;两种神经元排列紧密 ,但未见双标记神经元。面神经切断吻合后 4个月 ,颊支神经元与下颌缘支神经元仍主要呈交迭分布 ,但标记的神经元数明显减少 ,神经元排列松散 ,部分颊支和下颌缘支神经元分布到背侧、腹内侧和内侧亚核。面神经切断吻合后 6个月 ,颊支神经元与下颌缘支的分布方式与面神经吻合后 4个月时基本相同 ,但标记的神经元数明显增多 ,并见 1%～ 2 %的双标记神经元。结论　正常情况下面神经核内颊支神经元与下颌缘支神经元分布方式提示在颊支和下颌缘支的远端可能存在广泛的交通 ;神经损伤发生再支配后分布方式的变化则提示不同分支的运动神经元间存在错向再生     

延期神经再支配对大鼠失神经面肌功能的影响

目的 研究不同时间延期神经再支配对大鼠失神经面肌功能恢复程度的影响.方法 150只雄性SD大鼠随机分为正常对照组(n=10)、面神经损伤8周组(n=10)、面神经损伤16周组(n=10)、延期8周神经修复组(n=60)和延期16周神经修复组(n=60).以缝线结扎左侧面神经制造面神经损伤模型,分别于结扎后8周和16周行神经减压即延期神经再支配.采用诱发肌电图检测面肌动作电位最大振幅和潜伏期;采用肌肉Masson染色和神经干甲苯胺蓝染色,观察单位面积内肌纤维数目和平均直径、面神经有髓纤维数目.结果 面神经损伤组动物可见左侧面肌瘫痪,未见自发性恢复.延期8周神经修复组术后16周面肌功能恢复良好,面肌动作电位最大振幅可恢复至正常水平的75.55%,单位面积内有髓纤维数目、肌纤维数目和平均直径分别为正常值的72.26%(P＜0.05)、95.2%(P＞0.05)和93.79%(P＞0.05).而延期16周神经修复组术后16周面肌功能恢复差,单位面积内有髓纤维数目、肌纤维数目和平均直径分别为正常值的36.65%(P＜0.05)、69.33%(P＜0.05)和72.77%(P＜0.05).结论 适时延期神经修复可较好恢复面肌功能,虽然晚期神经修复效果差,但仍可恢复部分肌张力.     

自体非神经组织移植修复面神经缺损的实验研究

为探讨以自体非神经组织移植修复面神经缺损的可行法，采用自体变性骨骼肌和静脉修复免而神经上颊支8mm缺损，术后20周面神经缺损均获修复，再生神经形态和电传导功能与自体神经移植组比较差异无显著性。表明非神经组织可有效地引导神经再生并修复面神经缺损。提示该方法具有临床应用价值。     

应用HRP逆行示踪技术评价兔颞骨内面神经缺损的修复

目的 探讨几丁质室修复颞骨内面神经缺损神经纤维的再通以及与神经元胞体的连续性。方法 用几丁质室修复兔左侧颞骨内面神经缺损,术后1、3和5个月切断颞外段面神经主干,将辣根过氧化物酶（horseradish peroxidase,HRP）涂于其近端,同法标记正常神经对照组,观察脑桥下段的神经元细胞。结果 术后3个月在同侧腹外侧面神经运动核区出现数量不等的标记细胞。术后5个月数量增多,与正常神经的神经元胞体来源相同。结论 HRP可沿再生神经纤维逆行运输,表明神经纤维再通,周围支到中枢的解剖通路重建。     

面神经

20010687快速和缓慢面神经延长的实验研究/牙祖蒙…亨中华整形外科杂志一2000,伟(4)一229~232 日的:对快速和缓慢面神经延长进行比较研究.验证快速面神经延长的可行性,为临床应用神经延长术修复面神经缺损提供依据。方法:用自制的神经延长器以不同速度延长面神经颊支,快速延长组10mm/10min,缓慢延长组1.5一2.omm/d;在不同时间点检测颊肌肌电图(EMG)神经传导速度(NCV),并观察神经的病理形态学改变;在延长结束后切除一段神经再做端端外膜缝合,设神经移植组作为对照;自延长开始计时,第15周用EMG和NCV评估神经功能的恢复情况。结果:延长结…     

面神经

991734面神经在硅小室再生的研究/孙安…//第四军医大学学报一1999,20(1)一10~13 目的:观察硅小室技术对面神经损伤后神经修复形态学及再生过程的影响。方法:豚鼠面神经颊支缺损lomm,用硅小室桥接。采用光镜、透射电镜、图像分析及HRP逆行追踪法,观察面神经在硅小室再生过程中的形态学改变与证实神经的再通。结果:面神经损伤后第1周,硅小室内神经远、近心端再生神经分别向内生长全于2 .4mm;第:周,两断端神经已再通.,但较细;第10周,神经接近正常。电镜显示第4周起,有髓纤维的雪旺细胞(SC)功能活跃,细胞内可见丰富的粗面内质网、线粒体等;第…     

胰岛素样生长因子对面神经损伤的修复作用

目的探讨局部应用胰岛素样生长因子(IGF-1)对面神经损伤的修复作用.方法将20只成年新西兰兔面神经上颊支切除5mm,在断端间置入硅胶再生室,左右侧随机分组,采用自身对照,在实验耳室内注入IGF-1,对照耳用生理盐水,术后4周和8周进行电生理学、组织病理学观察和形态学定量分析.结果术后4周,两组电刺激面神经很少能引发面肌兴奋,有髓轴索计数,轴索直径和面积t检验,两组差异有显著性意义(P<0.05).术后8周实验耳运动神经传导速度(MCV)明显短于对照耳,有髓轴索计数,轴索直径和面积实验耳大于对照耳(P＜0.05).结论局部应用IGF-1可促进面神经损伤的修复.     

Rabbit facial nerve regeneration in autologous nerve grafts after antecedent injury

OBJECTIVE: The effect of incomplete antecedent injuries on subsequent facial nerve regeneration within cable graft repairs is not known. The purpose of this study is to compare facial nerve regeneration after an immediate and delayed neural cable graft repair. METHOD: Rabbit facial nerve regeneration after complete transectional injuries of the buccal division was compared in two experimental models. In one, a 10-mm segment of the nerve was transected, rotated 180 degrees, and immediately repaired as a cable graft (N=8). In the second, a preliminary nerve crush was allowed to recover over a 4-week period and a 10-mm segment of nerve centered on the crush site was then transected, rotated 180 degrees, and delay repaired as a cable graft (N = 7). Data are presented as total numbers of regenerating myelinated axons that traverse the surgical repair to innervate the cable graft and distal nerve stumps, as well as the percentage of regenerating neurites compared with preoperative pooled and individual controls. Subpopulations of regenerating neurons are delineated to quantify the pattern of neural innervation. RESULTS: Five weeks after cable graft repair both groups had similar myelinated outgrowth from the proximal nerve stump across the proximal anastomosis to innervate the cable graft (3995 +/- 1209 vs. 3284 +/- 651; P = .89). However, the delayed repair group had more intrafascicular regeneration within cable grafts (2261 +/- 931 vs. 1660 +/- 1169; P = .02) and distal nerve stump (1532 +/- 281 vs. 445 +/- 120; P = .004) than the immediate repair group. The immediate repair group had greater extrafascicular nerve regeneration in the cable graft (2335 +/- 1954 vs. 437 +/- 236; P = .001) and more myelin and axonal debris in pre-existing neural fascicles of the cable graft (P = .02) and distal nerve stump (463 +/- 187 vs. 103 +/- 87; P = .02). CONCLUSIONS: Antecedent priming lesions do not enhance axonal survival as determined by regenerating myelinated axonal counts. However, antecedent injuries enhance the efficiency of neural innervation of the affected mimetic musculature by increasing the number of myelinated intrafascicular neural regenerants in the cable graft and distal nerve stump. This is accomplished by two factors: increased perineural fibrosis and decreased intrafascicular myelin and axonal debris.     

Effect of platelet rich plasma and fibrin sealant on facial nerve regeneration in a rat model

OBJECTIVE: To investigate the effects of platelet rich plasma (PRP) and fibrin sealant (FS) on facial nerve regeneration. STUDY DESIGN: Prospective, randomized, and controlled animal study. METHODS: Experiments involved the transection and repair of facial nerve of 49 male adult rats. Seven groups were created dependant on the method of repair: suture; PRP (with/without suture); platelet poor plasma (PPP) (with/without suture); and FS (with/without suture) groups. Each method of repair was applied immediately after the nerve transection. The outcomes measured were: 1) observation of gross recovery of vibrissae movements within 8-week period after nerve transection and repair using a 5-point scale and comparing the left (test) side with the right (control) side; 2) comparisons of facial nerve motor action potentials (MAP) recorded before and 8 weeks after nerve transection and repair, including both the transected and control (untreated) nerves; 3) histologic evaluation of axons counts and the area of the axons. RESULTS: Vibrissae movement observation: the inclusion of suturing resulted in overall improved outcomes. This was found for comparisons of the suture group with PRP group; PRP with/without suture groups; and PPP with/without suture groups (P < .05). The PRP without suture group had a significantly greater degree of recovery than the PPP without suture group (P < .05), but it did not have better performance than suture group (P > .05). The movement recovery of the suture group was significantly better than the FS group (P = .014). The recovery of function of the PRP groups was better than that of the FS groups, although this did not reach statistical significance (P = .09). Electrophysiologic testing: there was a significantly better performance of the suture group when compared with the PRP and PPP without suture groups in nerve conduction velocity (P < .05). The PRP with suture group had the best results when compared with the suture as well as the PPP with suture groups in duration and latency-2 of MAP (P < .05). For the FS groups, no results were found demonstrating a biological effect. The PRP with suture group demonstrated the best performance in the latency-2 and the area under the curve of MAP when compared with the suture and FS with suture groups (P < .05). Histomorphometric analysis: PRP with suture demonstrated the greatest increase in axon counts when compared with suture, FS with suture, and PPP with suture groups (P < .05). There was no statistically significant difference seen in axon diameter. CONCLUSION: The best results for the return of function in our rat facial nerve axotomy models occurred when the nerve ends were sutured together. At the same time, the data demonstrated a measurable neurotrophic effect when PRP was present, with the most favorable results seen with PRP added to suture. There was an improved functional outcome with the use of PRP in comparison with FS or no bioactive agents (PPP). FS showed no benefit over conventional suturing in facial nerve regeneration. Our study provides the potential of a new clinical application for PRP in peripheral nerve regeneration.     

几丁质再生室修复面神经缺损的实验研究

寻求适合临床应用的可吸收性面神经修复材料。方法：用几丁质管作为人工再生室修复兔面神经颊支８ｍｍ缺损,观察神经再生及其功能恢复情况。结论可吸收性几丁质再生室能有效地引导面神经再生并恢复其功能,有一定的临床应用价值。     

Evaluation of the systemic use of riluzole in post-traumatic facial nerve regeneration: experimental study in rabbits

CONCLUSIONS: Riluzole promoted increase and/or preservation of axon density in the animals treated with this drug as compared to the control group; it did not increase the mean diameter of facial nerve fibres as compared to the non-treated group; and it did not provide a better functional motor recovery than in the control group. OBJECTIVE: Traumatic peripheral facial paralysis is a frequent affection. In incomplete nerve injuries, systemic drugs acting on regeneration may decrease the patient's period of morbidity. This study aimed to determine the effect of the drug riluzole on regeneration of the facial nerve of rabbits submitted to post-traumatic facial paralysis. MATERIALS AND METHODS: Eighteen rabbits were submitted to compression of the facial nerve and divided into control (A) and treated (B) groups. The animals were sacrificed 4 weeks after the injury and their nerves were studied regarding density of myelinated axons and measure of external axon diameters. RESULTS: Partial functional recovery was observed within 2 weeks and complete recovery 5 weeks after injury. Mean neural density was 12,679.7 axons/mm2 (SD+/-237.5) in group A, and 19,073.8 axons/mm2 (SD+/-3549.9) in group B. Group A presented less than two-thirds the density of group B. There was no statistical difference in axon diameters between the studied groups.     

睫状神经营养因子对面神经损伤的修复作用

目的：探讨局部应用睫状神经营养因子（ＣＮＴＦ）对成年大鼠面神经损伤的修复作用。方法：将雄性ＳＤ大鼠颞骨内面神经垂直段横断后端端吻合,ＣＮＴＦ组以ＣＮＴＦ明胶海绵覆盖损伤处;对照组以生理盐水（ＳＡＬ）的明胶海绵覆盖损伤处。术后ＣＮＴＦ组每周２次耳后皮不注射ＣＮＴＦ５μｇ,对照组同法注射等量ＳＡＬ。术后２,４和１２周各组进行电生理学、组织病理学观察及开矿学定量分析。结果：术后２周,两组电刺面神经均未能     

面神经再生液的采集及其蛋白质组学分析和生物活性检测

目的 :检测面神经再生液的蛋白质成分及对运动神经元的生物营养活性。方法 :建立面神经再生室的动物模型 ,采集面神经再生液 ,用双向凝胶电泳技术对再生液进行蛋白组学的研究 ,并应用运动神经元培养的方法检验其生物活性。结果 :再生液中检测到 (85 0± 78)个蛋白质斑点 ,实验组培养神经元的胞体面积、突起长度及光密度值总体上大于对照组。结论 :再生液中蛋白含量丰富 ,种类繁多 ,面神经再生液对运动神经元确有营养活性作用。     

神经生长因子在面神经损伤修复中作用的实验研究

OBJECTIVE: To elucidate the role of NGF in the regeneration of facial nerve. METHODS: The superior buccal division of facial nerve of adult New Zealand rabbit was transected and a nerve growth chamber created. The chamber of the experimental side was filled with NGF/normal saline and that of the control side with normal saline alone. Four and eight weeks after operation, the regenerated nerves in the chambers were dissected for histological studies. RESULTS: Four weeks after operation, the average thickness of myelin sheath and the average number of myelinated axons were 0.779 +/- 0.475 micron, 2.024 +/- 1.999 (n = 11) in experimental group and 0.413 +/- 0.132 micron, 368 +/- 171 (n = 8) in control sides respectively. There was significant difference between the experimental sides and control sides (P < 0.05). Eight weeks after operation, the regenerated nerve appeared more mature. There were significant difference in the average diameters, the thickness of myelin sheath and the number of myelinated axons between the experimental and control sides (P < 0.05). CONCLUSION: NGF within a silicone chamber enhanced facial nerve regeneration in New Zealand rabbits.     

Effects of pituitary adenylate cyclase-activating polypeptide on facial nerve recovery in the Guinea pig

OBJECTIVES/HYPOTHESIS: Pituitary adenylate cyclase-activating polypeptide (PACAP) has neurotrophic effects of neural regeneration and gives protection to the nervous system. We investigated whether PACAP had a neurotrophic effect on peripheral motoneurons and whether PACAP could facilitate glial cell line-derived neurotrophic factor (GDNF), a neurotrophin, in nerve regeneration. The presence and distribution of PACAP receptors following facial nerve transection were also investigated. STUDY DESIGN: Animal experiment. METHODS: Unilateral transection of the facial nerve was performed in male Hartley guinea pigs, and PACAP was injected at the site. Saline was substituted as a control. Compound muscle action potentials were recorded to measure the changes of latency. Glial cell line-derived neurotrophic factor (GDNF) content in facial target muscle was measured using enzyme-linked immunosorbent assay. The regenerating site was taken for histological studies. RESULTS: Pituitary adenylate cyclase-activating polypeptide hastened the appearance of compound muscle action potentials and shortened the latency. Pituitary adenylate cyclase-activating polypeptide increased and prolonged the nerve transection-induced GDNF increase in the facial muscles. The number of myelinated fibers at 1 to 4 weeks after the transection was increased. PAC1 receptor or VPAC1 receptor or both were identified in the injury area at 2 to 4 weeks. CONCLUSIONS: Pituitary adenylate cyclase-activating polypeptide facilitated the recovery of latency of compound muscle action potentials or the number of myelinated axons, or both. Pituitary adenylate cyclase-activating polypeptide prolonged the GDNF levels in target organs. These data indicated that PACAP promoted regeneration of the facial nerve.     

Experimental study on facial nerve regeneration with or without geniculate ganglionectomy

OBJECTIVE: To investigate regeneration of the distal facial nerve following nerve grafting within the tympanic segment with geniculate ganglion preservation or dissection. DESIGN: Randomized controlled trial. SUBJECTS: Twenty-three adult New Zealand albino rabbits were used in this study. INTERVENTIONS: A 2-mm tympanic segment of the facial nerve was removed, and the greater auricular nerve was harvested for grafting in all animals. In group 1 (10 rabbits), the geniculate ganglion was preserved. In group 2 (13 rabbits), the geniculate ganglion was dissected. Mastoidal and extratemporal segments of the facial nerve were harvested 3 months postoperatively for histological examination by electron microscopy. RESULTS: The number of myelinated axons in normal facial nerves was 1819.6 +/- 535.6. In group 1, the number of myelinated axons was 123.6 +/- 31.1, and, compared with normal facial nerves, the diameter of the regenerative axons was decreased and the sheath thickness in the regenerative fiber was diminished. In group 2, the number of myelinated axons was 515.1 +/- 103.1, while the myelin sheath thickness was proportionate to axon diameter. (Data are given as mean +/- SD.) CONCLUSION: Geniculate ganglionectomy may improve motor axon regeneration.     

豚鼠面神经损伤后面神经核中降钙素基因相关肽的变化

目的:探讨降钙素基因相关肽(CGRP)在面神经损伤再生过程中的作用.方法:采用免疫组化及图像分析技术,观察豚鼠面神经核中的CGRP在面神经损伤后含量和分布的变化.结果:CGRP分布于正常豚鼠面神经核各亚核.面神经损伤后1 d,损伤侧面神经核运动神经元中CGRP阳性反应增强,图像分析CGRP灰度值与对照侧比较,差异非常显著(P＜0.01);损伤后7 d达最高峰(P＜0.001),其后渐降.在损伤后14～35 d,发现显著的束状CGRP阳性纤维从面神经核腹侧向外周延伸.结论:面神经损伤后,面神经核中的CGRP含量和分布出现显著变化,提示CGRP在面神经修复再生过程中起着调控作用.