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Review of Drug Therapy for Peripheral Facial Nerve Regeneration That Can Be Used in Actual Clinical Practice. Biomedicines 2022; 10:biomedicines10071678. [PMID: 35884983 PMCID: PMC9313135 DOI: 10.3390/biomedicines10071678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Although facial nerve palsy is not a life-threatening disease, facial asymmetry affects interpersonal relationships, causes psychological stress, and devastates human life. The treatment and rehabilitation of facial paralysis has many socio-economic costs. Therefore, in cases of facial paralysis, it is necessary to identify the cause and provide the best treatment. However, until now, complete recovery has been difficult regardless of the treatment used in cases of complete paralysis of unknown cause and cutting injury of the facial nerve due to disease or accident. Therefore, this article aims to contribute to the future treatment of facial paralysis by reviewing studies on drugs that aid in nerve regeneration after peripheral nerve damage.
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Changes of Functional, Morphological, and Inflammatory Reactions in Spontaneous Peripheral Nerve Reinnervation after Thermal Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9927602. [PMID: 35154578 PMCID: PMC8826209 DOI: 10.1155/2022/9927602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/25/2021] [Accepted: 01/04/2022] [Indexed: 12/27/2022]
Abstract
In recent decades, the use of energy-based devices has substantially increased the incidence of iatrogenic thermal injury to nerves (cauterization, etc.). While recovery of the nerve after thermal injury is important, the changes in neural structure, function, and peripheral inflammatory reactions postinjury remain unclear. This study is aimed at demonstrating the changes mentioned above during the acute, subacute, and chronic stages of nerve reinnervation after thermal injury. Spontaneous reinnervation was evaluated, including the neural structures, nerve conduction abilities, and muscle regeneration. These effects vary depending on the severity of thermal injury (slight, moderate, and severe). Peripheral inflammatory reactions, as impediments to reinnervation, were found in significant numbers 3 days after thermal injury, exhibiting high expression of IL-1β and TNF-α, but low expression of IL-10. Our findings reveal the pathogenesis of peripheral nerve reinnervation after thermal injury, which will assist in selecting appropriate treatments in further research.
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Transmuscular Quadratus Lumborum Block in Total Hip Replacement: A Response. Clin J Pain 2021; 37:940-941. [PMID: 34757344 DOI: 10.1097/ajp.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lee JI, Hur JM, You J, Lee DH. Functional recovery with histomorphometric analysis of nerves and muscles after combination treatment with erythropoietin and dexamethasone in acute peripheral nerve injury. PLoS One 2020; 15:e0238208. [PMID: 32881928 PMCID: PMC7470391 DOI: 10.1371/journal.pone.0238208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Peripheral nerve injury (PNI) often leads to significant functional loss in patients and poses a challenge to physicians since treatment options for improving functional outcomes are limited. Recent studies suggest that erythropoietin and glucocoticoids have beneficial effects as mediators of neuro-regenerative processes. We hypothesized that combination treatment with erythropoietin and glucocoticoids would have a synergistic effect on functional outcome after PNI. Materials and methods Sciatic nerve crush injury was simulated in ten-week-old male C57BL/6 mice. The mice were divided into four groups according to the type of drugs administered (control, erythropoietin, dexamethasone, and erythropoietin with dexamethasone). Motor functional recovery was monitored by walking track analysis at serial time points up to 28 days after injury. Morphological analysis of the nerve was performed by immunofluorescent staining for neurofilament (NF) heavy chain and myelin protein zero (P0) in cross-sectional and whole-mount nerve preparations. Additionally, morphological analysis of the muscle was performed by Hematoxylin and eosin staining. Results Combination treatment with erythropoietin and dexamethasone significantly improved the sciatic functional index at 3, 7, 14, and 28 days after injury. Fluorescence microscopy of cross sectional nerve revealed that the combination treatment increased the ratio of P0/NF-expressing axons. Furthermore, confocal microscopy of the whole-mount nerve revealed that the combination treatment increased the fluorescence intensity of P0 expression. The cross-sectional area and minimum Feret’s diameter of the muscle fibers were significantly larger in the mice which received combination treatment than those in the controls. Conclusion Our results demonstrated that combination treatment with erythropoietin and dexamethasone accelerates functional recovery and reduces neurogenic muscle atrophy caused by PNI in mice, which may be attributed to the preservation of myelin and Schwann cell re-myelination. These findings may provide practical therapeutic options for patients with acute PNI.
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Affiliation(s)
- Jung Il Lee
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
- College of Medicine, Hanyang University, Seoul, South Korea
- * E-mail:
| | - Jeong Min Hur
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Jooyoung You
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Duk Hee Lee
- Department of Emergency Medicine, Ewha Women's University Mokdong Hospital, Seoul, South Korea
- College of Medicine, Ewha Women's University, Seoul, South Korea
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Vest M, Guida A, Colombini C, Cordes K, Pena D, Maki M, Briones M, Antonio S, Hollifield C, Tian E, James L, Borashan C, Woodson J, Rovig J, Shihadeh H, Karabachev A, Brosious J, Pistorio A. Closing the Gap Between Mammalian and Invertebrate Peripheral Nerve Injury: Protocol for a Novel Nerve Repair. JMIR Res Protoc 2020; 9:e18706. [PMID: 32851981 PMCID: PMC7484768 DOI: 10.2196/18706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Outcomes after peripheral nerve injuries are poor despite current nerve repair techniques. Currently, there is no conclusive evidence that mammalian axons are capable of spontaneous fusion after transection. Notably, certain invertebrate species are able to auto-fuse after transection. Although mammalian axonal auto-fusion has not been observed experimentally, no mammalian study to date has demonstrated regenerating axolemmal membranes contacting intact distal segment axolemmal membranes to determine whether mammalian peripheral nerve axons have the intrinsic mechanisms necessary to auto-fuse after transection. OBJECTIVE This study aims to assess fusion competence between regenerating axons and intact distal segment axons by enhancing axon regeneration, delaying Wallerian degeneration, limiting the immune response, and preventing myelin obstruction. METHODS This study will use a rat sciatic nerve model to evaluate the effects of a novel peripheral nerve repair protocol on behavioral, electrophysiologic, and morphologic parameters. This protocol consists of a variety of preoperative, intraoperative, and postoperative interventions. Fusion will be assessed with electrophysiological conduction of action potentials across the repaired transection site. Axon-axon contact will be assessed with transmission electron microscopy. Behavioral recovery will be analyzed with the sciatic functional index. A total of 36 rats will be used for this study. The experimental group will use 24 rats and the negative control group will use 12 rats. For both the experimental and negative control groups, there will be both a behavior group and another group that will undergo electrophysiological and morphological analysis. The primary end point will be the presence or absence of action potentials across the lesion site. Secondary end points will include behavioral recovery with the sciatic functional index and morphological analysis of axon-axon contact between regenerating axons and intact distal segment axons. RESULTS The author is in the process of grant funding and institutional review board approval as of March 2020. The final follow-up will be completed by December 2021. CONCLUSIONS In this study, the efficacy of the proposed novel peripheral nerve repair protocol will be evaluated using behavioral and electrophysiologic parameters. The author believes this study will provide information regarding whether spontaneous axon fusion is possible in mammals under the proper conditions. This information could potentially be translated to clinical trials if successful to improve outcomes after peripheral nerve injury. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/18706.
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Affiliation(s)
- Maxwell Vest
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Addison Guida
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Cory Colombini
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Kristina Cordes
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Diana Pena
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Marwa Maki
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Michael Briones
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Sabrina Antonio
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Carmen Hollifield
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Elli Tian
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Lucas James
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Christian Borashan
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Johnnie Woodson
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - John Rovig
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Hanaa Shihadeh
- Larner College of Medicine, University of Vermont, Burlington, VT, United States
| | - Alexander Karabachev
- Larner College of Medicine, University of Vermont, Burlington, VT, United States
| | - John Brosious
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Ashley Pistorio
- Department of Plastic and Reconstructive Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States
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Xu W, Ding W, Sheng H, Lu D, Xu X, Xu B. Dexamethasone Suppresses Radicular Pain Through Targeting the L-PGDS/PI3K/Akt Pathway in Rats With Lumbar Disc Herniation. Pain Pract 2020; 21:64-74. [PMID: 32640501 DOI: 10.1111/papr.12934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/21/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Lumbar disc herniation (LDH) is a frequently occurring disease with unknown etiology, which makes treatment a challenge. The aim of this study was to analyze the effects of dexamethasone on LDH and elucidate the underlying mechanisms. GENERAL METHODS An LDH rat model was established by nucleus pulposus implantation. The activity of the lipocalin type prostaglandin D synthase (L-PGDS)/phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) axis was evaluated by Western blotting. Paw withdrawal threshold and paw withdrawal latency were assessed by the Von Frey hairs method and the thermal dolorimeter of Hargreaves, respectively. The 21-point Basso-Beattie-Bresnahan scale was used to assess the locomotor function of rats. Pathological changes in the affected region were analyzed by hematoxylin-eosin staining. Immunofluorescence was used to measure the expression of microtubule-associated protein (MAP-2). FINDINGS Lumbar disc herniation markedly increased thermo-mechanical allodynia and induced dorsal root ganglion (DRG) degeneration by inactivating the L-PGS/PI3K/Akt pathway. Dexamethasone restored the L-PGDS/PI3K/Akt pathway and relieved LDH-induced thermo-mechanical allodynia. Furthermore, overexpression and knockdown of L-PGDS respectively attenuated and worsened LDH-triggered thermo-mechanical allodynia and tissue degeneration by modulating the PI3K/Akt pathway. Pretreatment with dexamethasone partially abrogated the effect of L-PGDS knockdown through PI3K/Akt activation. CONCLUSIONS Dexamethasone relieves LDH-mediated radicular pain by exerting anti-inflammatory effects and reducing the suppression of L-PGDS induced by LDH. Meanwhile, the activity of the PI3K/Akt pathway was decreased, possibly due to the attenuated inflammation induced by dexamethasone. Our results revealed the underlying mechanism of dexamethasone, which might be helpful in reducing the side effects of dexamethasone and provide more focused therapy in LDH.
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Affiliation(s)
- Weixing Xu
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Weiguo Ding
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Hongfeng Sheng
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Di Lu
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xinwei Xu
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Bin Xu
- Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
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Haidar MK, Timur SS, Kazanci A, Turkoglu OF, Gürsoy RN, Nemutlu E, Sargon MF, Bodur E, Gök M, Ulubayram K, Öner L, Eroğlu H. Composite nanofibers incorporating alpha lipoic acid and atorvastatin provide neuroprotection after peripheral nerve injury in rats. Eur J Pharm Biopharm 2020; 153:1-13. [PMID: 32504798 DOI: 10.1016/j.ejpb.2020.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/25/2020] [Accepted: 05/31/2020] [Indexed: 12/27/2022]
Abstract
Despite the new treatment strategies within the last 30 years, peripheral nerve injury (PNI) is still a worldwide clinical problem. The incidence rate of PNIs is 1 in 1000 individuals per year. In this study, we designed a composite nanoplatform for dual therapy in peripheral nerve injury and investigated the in-vivo efficacy in rat sciatic nerve crush injury model. Alpha-lipoic acid (ALA) was loaded into poly lactic-co-glycolic acid (PLGA) electrospun nanofibers which would release the drug in a faster manner and atorvastatin (ATR) loaded chitosan (CH) nanoparticles were embedded into PLGA nanofibers to provide sustained release. Sciatic nerve crush was generated via Yasargil aneurism clip with a holding force of 50 g/cm2. Nanofiber formulations were administered to the injured nerve immediately after trauma. Functional recovery of operated rat hind limb was evaluated using the sciatic functional index (SFI), extensor postural thrust (EPT), withdrawal reflex latency (WRL) and Basso, Beattie, and Bresnahan (BBB) test up to one month in the post-operative period at different time intervals. In addition to functional recovery assessments, ultrastructural and biochemical analyses were carried out on regenerated nerve fibers. L-929 mouse fibroblast cell line and B35 neuroblastoma cell line were used to investigate the cytotoxicity of nanofibers before in-vivo experiments. The neuroprotection potential of these novel nanocomposite fiber formulations has been demonstrated after local implantation of composite nanofiber sheets incorporating ALA and ATR, which contributed to the recovery of the motor and sensory function and nerve regeneration in a rat sciatic nerve crush injury model.
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Affiliation(s)
- Mohammad Karim Haidar
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey; Department of Pharmaceutical Technology, Faculty of Pharmacy, Erzincan Binali Yıldırım University, 24100 Erzincan, Turkey
| | - Selin Seda Timur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey
| | - Atilla Kazanci
- Department of Neurosurgery Faculty of Medicine, Ankara Yıldırım Beyazıt University, 06810 Ankara, Turkey
| | - Omer Faruk Turkoglu
- Department of Neurosurgery, City Hospital, Turkish Republic Ministry of Health, 06810 Ankara, Turkey
| | - R Neslihan Gürsoy
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey
| | - Mustafa Fevzi Sargon
- Department of Anatomy, School of Medicine, Atilim University, 06830 Ankara, Turkey
| | - Ebru Bodur
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey
| | - Müslüm Gök
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey
| | - Kezban Ulubayram
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Hacettepe University 06100 Ankara, Turkey
| | - Levent Öner
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey
| | - Hakan Eroğlu
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Hacettepe University, 06100 Ankara, Turkey.
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Clark AR, Hsu CG, Talukder MAH, Noble M, Elfar JC. Transdermal delivery of 4-aminopyridine accelerates motor functional recovery and improves nerve morphology following sciatic nerve crush injury in mice. Neural Regen Res 2020; 15:136-144. [PMID: 31535662 PMCID: PMC6862422 DOI: 10.4103/1673-5374.264471] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Oral 4-aminopyridine (4-AP) is clinically used for symptomatic relief in multiple sclerosis and we recently demonstrated that systemic 4-AP had previously unknown clinically-relevant effects after traumatic peripheral nerve injury including the promotion of re-myelination, improvement of nerve conductivity, and acceleration of functional recovery. We hypothesized that, instead of oral or injection administration, transdermal 4-AP (TD-4-AP) could also improve functional recovery after traumatic peripheral nerve injury. Mice with surgical traumatic peripheral nerve injury received TD-4AP or vehicle alone and were examined for skin permeability, pharmacokinetics, functional, electrophysiological, and nerve morphological properties. 4-AP showed linear pharmacokinetics and the maximum plasma 4-AP concentrations were proportional to TD-4-AP dose. While a single dose of TD-4-AP administration demonstrated rapid transient improvement in motor function, chronic TD-4-AP treatment significantly improved motor function and nerve conduction and these effects were associated with fewer degenerating axons and thicker myelin sheaths than those from vehicle controls. These findings provide direct evidence for the potential transdermal applicability of 4-AP and demonstrate that 4-AP delivered through the skin can enhance in-vivo functional recovery and nerve conduction while decreasing axonal degeneration. The animal experiments were approved by the University Committee on Animal Research (UCAR) at the University of Rochester (UCAR-2009-019) on March 31, 2017.
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Affiliation(s)
- Andrew R Clark
- Department of Orthopaedics, The University of Rochester Medical Center, Rochester, NY, USA
| | - Chia George Hsu
- Department of Medicine, Aab Cardiovascular Research Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - M A Hassan Talukder
- Center for Orthopaedic Research and Translational Science, Penn State Hershey College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mark Noble
- Department of Biomedical Genetics, The University of Rochester Medical Center, Rochester, NY, USA
| | - John C Elfar
- Center for Orthopaedic Research and Translational Science, Penn State Hershey College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, USA
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Modrak M, Talukder MAH, Gurgenashvili K, Noble M, Elfar JC. Peripheral nerve injury and myelination: Potential therapeutic strategies. J Neurosci Res 2019; 98:780-795. [PMID: 31608497 DOI: 10.1002/jnr.24538] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
Traumatic peripheral nerve injury represents a major clinical and public health problem that often leads to significant functional impairment and permanent disability. Despite modern diagnostic procedures and advanced microsurgical techniques, functional recovery after peripheral nerve repair is often unsatisfactory. Therefore, there is an unmet need for new therapeutic or adjunctive strategies to promote the functional recovery in nerve injury patients. In contrast to the central nervous system, Schwann cells in the peripheral nervous system play a pivotal role in several aspects of nerve repair such as degeneration, remyelination, and axonal growth. Several non-surgical approaches, including pharmacological, electrical, cell-based, and laser therapies, have been employed to promote myelination and enhance functional recovery after peripheral nerve injury. This review will succinctly discuss the potential therapeutic strategies in the context of myelination following peripheral neurotrauma.
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Affiliation(s)
- Max Modrak
- School of Medicine & Dentistry, The University of Rochester Medical Center, Rochester, New York, USA
| | - M A Hassan Talukder
- Department of Orthopaedics & Rehabilitation, Penn State Hershey College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Khatuna Gurgenashvili
- Department of Neurology, Penn State Hershey College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Mark Noble
- Department of Biomedical Genetics, The University of Rochester Medical Center, Rochester, New York, USA
| | - John C Elfar
- Department of Orthopaedics & Rehabilitation, Penn State Hershey College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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Alvites R, Rita Caseiro A, Santos Pedrosa S, Vieira Branquinho M, Ronchi G, Geuna S, Varejão AS, Colette Maurício A. Peripheral nerve injury and axonotmesis: State of the art and recent advances. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1466404] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Rui Alvites
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Ana Rita Caseiro
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
- Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia, Universidade do Porto (REQUIMTE/LAQV), R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Sílvia Santos Pedrosa
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Mariana Vieira Branquinho
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
| | - Giulia Ronchi
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Stefano Geuna
- Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Artur S.P. Varejão
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Department of Clinical and Biological Sciences, and Cavalieri Ottolenghi Neuroscience Institute, University of Turin, Ospedale San Luigi, 10043 Orbassano, Turin, Italy
| | - Ana Colette Maurício
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, nº 228, 4050-313 Porto, Portugal
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Türedi S, Yuluğ E, Alver A, Bodur A, İnce İ. A morphological and biochemical evaluation of the effects of quercetin on experimental sciatic nerve damage in rats. Exp Ther Med 2018; 15:3215-3224. [PMID: 29545838 PMCID: PMC5841083 DOI: 10.3892/etm.2018.5824] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/03/2017] [Indexed: 12/28/2022] Open
Abstract
The present study evaluated the neuroprotective and antioxidant effects of quercetin in a rat model of sciatic nerve crush injury using histopathological, morphometric and biochemical methods. A total of 48 male Sprague Dawley rats, aged 10-12 weeks old were randomly divided into eight groups, consisting of two sham groups (S-7, S-28), three quercetin-treated groups (Q-7, Q-28; 200 mg/kg/7 days), trauma (T-7, T-28; 1 min sciatic nerve crush injury) and three trauma+quercetin groups (T+Q-7, T+Q-28; trauma+quercetin 200 mg/kg/7 days). Rats were sacrificed on day 7 or 28. Oxidant-antioxidant biochemical parameters in nerve tissues from all groups were analyzed using histopathological staining with toluidine blue and Masson's trichrome. DNA fragmentations were identified using terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling in cells from each tissue sample. Degeneration of the axons and myelin sheath, the breakdown of the concentric lamellar structure of the myelin sheath and axonal swelling were observed in groups T-7 and T-28. Myelin sheath thicknesses, nerve fiber diameters and the number of myelinated nerve fibers decreased, while the apoptotic index (AI) increased in the T-7 and T-28 groups. However, it was observed that nerve regeneration began in the T+Q-7 and T+Q-28 groups compared with the sham groups, together with the healing of cellular damage and axonal structure and a decrease in the AI. Malondialdehyde and superoxide dismutase activity did not differ significantly between the T-7 and S-7 groups. However, catalase activity significantly decreased in the T-28 group when compared with the sham 7 day group. Tissue malondialdehyde levels significantly increased, while serum catalase activity increased in the T+Q-7 group compared with the T-7 group. These results suggest that quercetin has beneficial effects on nerve regeneration and may shorten the healing period in crush-type sciatic nerve injuries.
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Affiliation(s)
- Sibel Türedi
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Esin Yuluğ
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Ahmet Alver
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Akin Bodur
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - İmran İnce
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
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Devine M, Modgill O, Renton T. Mandibular division trigeminal nerve injuries following primary endodontic treatment. A case series. AUST ENDOD J 2017; 43:56-65. [DOI: 10.1111/aej.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Maria Devine
- Department of Oral Surgery; Dental Institute; Kings College Hospital NHS Foundation Trust; London UK
| | - Omesh Modgill
- Department of Oral Surgery; Dental Institute; Kings College Hospital NHS Foundation Trust; London UK
| | - Tara Renton
- Department of Oral Surgery; Dental Institute; Kings College Hospital NHS Foundation Trust; London UK
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Devine M, Yilmaz Z, Hirani M, Renton T. A case series of trigeminal nerve injuries caused by periapical lesions of mandibular teeth. Br Dent J 2017; 222:447-455. [PMID: 28337002 DOI: 10.1038/sj.bdj.2017.268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/09/2022]
Abstract
Aims Periapical lesions have been implicated in mandibular trigeminal sensory neuropathy. This study aimed to report on a case series of consecutive patients presenting with mandibular division trigeminal nerve injuries (TNI) caused by periapical lesions. Common presenting characteristics and possible strategies for management were also investigated.Materials and methods A retrospective study of 22 patients with TNI caused by periapical lesions. Data were extracted from patient records and analysed using Microsoft Excel and SPSS. Factors associated with TNI resolution were assessed using Student's t-Tests and one-way Analysis of Variance (ANOVA), where P <0.05 indicated statistical significance.Results Twenty-one patients had inferior alveolar nerve injuries (IANI) and one had a lingual nerve injury (LNI). The most commonly affected teeth were the first molars (11 patients; 50%). TNI symptoms included numbness, pain and/or paraesthesia. IANI resolved completely among five patients within a mean time of 4.7 months (range 1.5-12 months). Patients who showed complete resolution had the affected teeth extracted or primary endodontic treatment with antibiotics.Conclusions Patients with TNI caused by periapical lesions can suffer significantly from combined numbness, pain and paraesthesia. Resolution of these injuries may be maximised upon early diagnosis and treatment of the periapical lesion by tooth extraction or primary endodontic treatment.
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Affiliation(s)
| | | | | | - T Renton
- King's College London Dental Institute, Oral Surgery, Denmark Hill Campus, Bessemer Road, London, SE5 9RS
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Bernstein DT, Weiner BK, Tasciotti E, Mathis KB. Does the combination of erythropoietin and tapered oral corticosteroids improve recovery following iatrogenic nerve injury? Injury 2016; 47:1819-23. [PMID: 27287740 DOI: 10.1016/j.injury.2016.05.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/15/2016] [Accepted: 05/24/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The reported prognosis for recovery after peripheral nerve injury is remarkably poor. Deficits may persist for years, resulting in significant functional disability. Both corticosteroids and Erythropoietin have been investigated as neuroprotective agents; however, their efficacy in total hip and knee arthroplasty is not known. The purpose of this study was to evaluate the effect of systemically-administered Erythropoietin and tapered oral corticosteroids on the recovery of postoperative nerve palsies in the setting of total hip and knee arthroplasty. METHODS Eleven patients sustaining postoperative peripheral nerve injuries after total hip or knee arthroplasty were treated acutely with Erythropoietin and tapered oral steroids. Motor and sensory function was assessed clinically pre- and postoperatively until complete motor recovery or for a minimum of 1 year. RESULTS Motor loss was complete in seven (64%) patients and partial in four (36%). Seven (64%) patients' symptoms affected the common peroneal nerve distribution and four (36%) had concomitant tibial nerve involvement. Eight (73%) patients experienced full motor recovery at an average of 39 days (range: 3-133 days), and three (27%) had near-complete motor recovery. At final follow up, no patient required assistive devices for ambulation. CONCLUSIONS Administration of Erythropoietin coupled with oral tapered steroids for patients sustaining iatrogenic nerve injuries in total hip and knee arthroplasty demonstrated faster and more complete recovery of motor and sensory function compared to previous reports in the literature. This study highlights the importance of further investigation to define the role of each in the setting of acute postoperative nerve palsies. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Derek T Bernstein
- Houston Methodist Hospital, Department of Orthopaedic Surgery, 6550 Fannin Street, Smith Tower, Suite 2500, Houston, TX, 77030, United States.
| | - Bradley K Weiner
- Houston Methodist Hospital, Department of Orthopaedic Surgery, 6550 Fannin Street, Smith Tower, Suite 2500, Houston, TX, 77030, United States; The Methodist Hospital Research Institute, Department of Nanomedicine, 6670 Bertner Avenue, Houston, TX, 77030, United States
| | - Ennio Tasciotti
- The Methodist Hospital Research Institute, Department of Nanomedicine, 6670 Bertner Avenue, Houston, TX, 77030, United States
| | - Kenneth B Mathis
- Houston Methodist Hospital, Department of Orthopaedic Surgery, 6550 Fannin Street, Smith Tower, Suite 2500, Houston, TX, 77030, United States
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An Experimental Comparison of the Effects of Propolis, Curcumin, and Methylprednisolone on Crush Injuries of the Sciatic Nerve. Ann Plast Surg 2015; 74:684-92. [DOI: 10.1097/sap.0000000000000026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jang CH, Cho YB, Choi CH, Jang YS, Jung WK. Effect of topical dexamethasone in reducing dysfunction after facial nerve crush injury in the rat. Int J Pediatr Otorhinolaryngol 2014; 78:960-3. [PMID: 24735605 DOI: 10.1016/j.ijporl.2014.03.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To date, the effect of topical steroid after a crush injury to rat facial nerve has rarely been reported on. The aim of this study was to investigate the effects of topical dexamethasone on recovery after a crush injury to the rat facial nerve, by functional, electrophysiological, and morphological evaluation. MATERIALS AND METHODS We investigated the effects of topical dexamethasone on recovery after a crush injury to rat facial nerve by functional, electrophysiological and morphological evaluation. RESULTS The functional recovery using vibrissae movement was significantly high scores in the experimental group than control group at two and three weeks post-crush. The recovery of the threshold of muscle action potential was significantly lowered in the experimental group compared to the control (p<0.05). However, there was no statistical significance in the nerve conduction velocity. The dexamethasone treatment groups showed a larger axon diameter and thicker myelin sheath than the control group. CONCLUSION From our results, topical dexamethasone accelerates recovery of the crush-injured facial nerve.
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Affiliation(s)
- Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea.
| | - Yong Beom Cho
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea
| | - Cheol Hee Choi
- Department of Bio New Drug Development, Chosun University, Gwangju, South Korea
| | - Yoon Seok Jang
- Department of Bio New Drug Development, Chosun University, Gwangju, South Korea
| | - Won-Kyo Jung
- Department of Biomedical Enginnering, and Center for Marine-Integrated Biomedical Technology (BK21 Plus), Pukyong National University, Pusan, South Korea
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Pourdanesh F, Khayampour A, Jamilian A. Therapeutic effects of local application of dexamethasone during bilateral sagittal split ramus osteotomy surgery. J Oral Maxillofac Surg 2014; 72:1391-4. [PMID: 24576440 DOI: 10.1016/j.joms.2013.12.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 12/19/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Bilateral sagittal split ramus osteotomy (BSSO) is one of the most common procedures used in the treatment of mandibular deformity. One common complication of this surgical procedure is hypoesthesia of the inferior alveolar nerve. The authors hypothesized that perioperative local application of dexamethasone would have positive therapeutic effects on neurosensory function. MATERIALS AND METHODS This study investigated 18 patients (10 male, 8 female; mean age, 26.1 ± 4.9 yr) who underwent BSSO. One side of each patient's mandible was randomly selected as the control side and the opposite side as the experimental side. A solution of dexamethasone 4 mg/1 mL was drawn into a syringe and poured directly on the distal segment of the exposed inferior alveolar nerve during splitting and 1 mL was poured on the same nerve immediately before the start of fixation. Neurosensory tests, including light touch, direction of movement, static 2-point touch, thermal stimuli, and pin prick discrimination, were conducted. The χ(2) and Fisher exact tests were used to evaluate the data. RESULTS The difference between the control and experimental groups at all intervals was not significant for any of the neurosensory tests. CONCLUSION Local application of dexamethasone on the exposed inferior alveolar nerve during BSSO is not recommended.
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Affiliation(s)
- Fereydoun Pourdanesh
- Associate Professor, Department of Oromaxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Khayampour
- Chief Resident, Oral and Maxillofacial Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolreza Jamilian
- Associate Professor, Fellow of Orthognathic Surgery, Department of Orthodontics, Dental Branch, Islamic Azad University, Tehran, Iran.
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Dexamethasone topically accelerates peripheral nerve repair and target organ reinnervation: a transected sciatic nerve model in rat. Injury 2013; 44:565-9. [PMID: 23131678 DOI: 10.1016/j.injury.2012.10.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/02/2012] [Accepted: 10/14/2012] [Indexed: 02/02/2023]
Abstract
The objective was to assess the effect of topically administered dexamethasone on peripheral nerve regeneration and functional recovery. Sixty male healthy white Wistar rats were divided into four experimental groups (n = 15), randomly: in transected group (TC), left sciatic nerve was transected and stumps were fixed in the adjacent muscle. In treatment group defect was bridged using a silicone tube (SIL/Dexa) filled with 10 μL dexamethasone (0.1 mg/kg). In silicone group (SIL), the tube was filled with phosphate-buffered saline alone. In sham-operated group (SHAM), sciatic nerve was exposed and manipulated. Each group was subdivided into three subgroups of five animals each and regenerated nerve fibres were studied 4, 8 and 12 weeks after surgery. Functional study, gastrocnemius muscle mass and morphometric indices confirmed faster recovery of regenerated axons in SIL/Dexa than SIL group (p < 0.05). In immunohistochemistry, location of reactions to S-100 in SIL/Dexa was clearly more positive than that in SIL group. When loaded in a silicone tube, dexamethasone improved functional recovery and morphometric indices of sciatic nerve. Topical application of this readily available agent offers the benefit of cost savings as well as avoiding the complications associated with systemic administration.
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Mohammadi R, Amini K, Eskafian H. Betamethasone-enhanced vein graft conduit accelerates functional recovery in the rat sciatic nerve gap. J Oral Maxillofac Surg 2012; 71:786-92. [PMID: 23084563 DOI: 10.1016/j.joms.2012.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 07/28/2012] [Accepted: 08/08/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of the study was to assess the effect of topically administered betamethasone on peripheral nerve regeneration and functional recovery after sciatic nerve transection in the rat. MATERIALS AND METHODS Forty-five healthy male white Wistar rats were divided into 3 experimental groups (n = 15), randomly. In the treatment group, a 10-mm sciatic nerve defect was bridged by use of an inside-out vein graft filled with 10 μL betamethasone (0.1 mg/kg) (IOVG/BETA group). In the control group, the vein was filled with phosphate-buffered saline solution alone (IOVG group). In the sham surgery group, the sciatic nerve was exposed with no further deleterious manipulations (SHAM group). Each group was subdivided into 3 subgroups of 5 animals each, and the regenerated nerve fibers were studied 4, 8, and 12 weeks after surgery. RESULTS Functional study confirmed faster recovery of regenerated axons in the IOVG/BETA group than in the IOVG group (P < .05). Gastrocnemius muscle mass in the IOVG/BETA group was found to be significantly greater than that in the IOVG group (P < .05). Morphometric indices of the regenerated fibers showed that the number and diameter of the myelinated fibers were significantly higher in the IOVG/BETA group than in the control group (P < .05). By use of immunohistochemistry, the location of reactions to S-100 in IOVG/BETA was clearly more positive than that in the IOVG group. CONCLUSIONS When loaded in a vein graft, betamethasone resulted in improvement of functional recovery and quantitative morphometric indices of sciatic nerve. Topical application of this readily available agent offers the benefit of cost savings, as well as avoiding the complications associated with systemic administration.
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Affiliation(s)
- Rahim Mohammadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
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Seth R, Revenaugh PC, Kaltenbach JA, Rajasekaran K, Meltzer NE, Ghosh D, Alam DS. Facial nerve neurorrhaphy and the effects of glucocorticoids in a rat model. Otolaryngol Head Neck Surg 2012; 147:832-40. [PMID: 22807488 DOI: 10.1177/0194599812451551] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE After nerve injury, an exaggerated neuroinflammatory process may hinder neuron regeneration and recovery. Immunomodulation using glucocorticoids may therefore improve facial nerve injury outcomes. This study aims to examine the effect of both local and systemic dexamethasone administration on facial nerve functional recovery after axotomy in a rat model. STUDY DESIGN Randomized, placebo-controlled, blinded animal study. Setting Animal laboratory. SUBJECTS AND METHODS Seventy-four Wistar rats underwent facial nerve axotomy with immediate neurorrhaphy. Rats were randomly assigned a postoperative group: control (no therapy); systemic dexamethasone 0.5, 1, 5, or 10 mg/kg for 3 administrations; or topically applied dexamethasone at 2 or 4 mg/mL. Blinded, standardized facial assessments and nerve conduction studies (NCS) were performed. Gross facial motion assessments were corroborated with vibrissae frequency video analysis. RESULTS At 8 weeks, rats receiving systemic dexamethasone at 5 mg/kg attained greater eye blink closure (P = .004) and vibrissae motion (P = .012) compared with controls. Systemic dexamethasone at 0.5, 1, and 10 mg/kg and intraoperative topical application of dexamethasone at 2 or 4 mg/mL did not produce a significant improvement in facial motion compared with controls. Nerve conduction studies show a trend of increased return of compound muscle action potential amplitude levels compared with baseline among rats that received systemic dexamethasone 5 mg/kg but do not achieve statistical significance. CONCLUSION In a rat facial nerve axotomy model, high-dose systemic dexamethasone therapy may improve functional recovery when administered in the immediate period following neurorrhaphy.
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Affiliation(s)
- Rahul Seth
- Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA
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Kim JE, Shim JS, Huh JB, Rim JS, Lee JY, Shin SW. Altered sensation caused by peri-implantitis: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 116:e9-13. [PMID: 22749709 DOI: 10.1016/j.oooo.2011.10.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 10/14/2011] [Accepted: 10/31/2011] [Indexed: 11/27/2022]
Abstract
Frequently reported is a case wherein a lesion caused by periodontitis or periapical lesion in a natural tooth enlarged, invaded the inferior alveolar nerve canal, and induced paresthesia. Cases wherein paresthesia occurred because of peri-implantitis have been rarely reported. The patient in this case report had experienced transient paresthesia after implant placement and recovered normal sensation 3 months later. Thirteen years later, this patient visited the authors' hospital with paresthesia in the same region because the peri-implantitis progressed to the apex of the implant. One week after removal of the implant, sense recovery and pain relief started, and 15 days after removal, the paresthesia and pain completely disappeared. For patients who experience transient paresthesia and recovery owing to nerve damage caused by the placement of an implant in the mandibular molar or premolar area, or in patients in whom the implant is close to the inferior alveolar nerve canal or the mental nerve, the spread of inflammation caused by peri-implantitis can induce paresthesia.
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Affiliation(s)
- Jong-Eun Kim
- Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute for Clinical Dental Research, KUMC, Korea University, Seoul, Korea
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Leung D, Greenberg JS, Henning PT, Chiodo AE. Cervical transforaminal epidural injection in the management of a stinger. PM R 2012; 4:73-7. [PMID: 22269456 DOI: 10.1016/j.pmrj.2011.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 08/25/2011] [Accepted: 09/12/2011] [Indexed: 10/14/2022]
Affiliation(s)
- Daniel Leung
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, 325 E Eisenhower Parkway, Ann Arbor, MI 48108, USA.
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Juodzbalys G, Wang HL, Sabalys G. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2011; 2:e1. [PMID: 24421983 PMCID: PMC3886063 DOI: 10.5037/jomr.2011.2101] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 01/10/2011] [Indexed: 12/25/2022]
Abstract
Objectives The purpose of present article was to review aetiological factors,
mechanism, clinical symptoms, and diagnostic methods as well as to
create treatment guidelines for the management of inferior alveolar
nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane
electronic databases. The keywords used for search were inferior
alveolar nerve injury, inferior alveolar nerve injuries, inferior
alveolar nerve injury implant, inferior alveolar nerve damage, inferior
alveolar nerve paresthesia and inferior alveolar nerve repair. The
search was restricted to English language articles, published from 1972
to November 2010. Additionally, a manual search in the major anatomy,
dental implant, periodontal and oral surgery journals and books were
performed. The publications there selected by including clinical, human
anatomy and physiology studies. Results In total 136 literature sources were obtained and reviewed. Aetiological
factors of inferior alveolar nerve injury, risk factors, mechanism,
clinical sensory nerve examination methods, clinical symptoms and
treatment were discussed. Guidelines were created to illustrate the
methods used to prevent and manage inferior alveolar nerve injury before
or after dental implant placement. Conclusions The damage of inferior alveolar nerve during the dental implant
placement can be a serious complication. Clinician should recognise and
exclude aetiological factors leading to nerve injury. Proper presurgery
planning, timely diagnosis and treatment are the key to avoid nerve
sensory disturbances management.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Hom-Lay Wang
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Gintautas Sabalys
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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Mandibular nerve neurosensory impairment after dental implant surgery: management and protocol. IMPLANT DENT 2011; 19:378-86. [PMID: 20881808 DOI: 10.1097/id.0b013e3181effa92] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
More than 70% of dentists have experienced patients with postoperative paresthesia/dysesthesia or anesthesia as a result of dental procedures. The most common nerve affected is the mandibular nerve, which may be injured during either implant surgery or bone grafting procedures. However, no organized protocol directed specifically for general dentists, or for the vast majority of specialists, has been published. The protocol presented in this article is divided into 5 periods: during surgery (1) nerve injury is suspected or (2) known nerve transection, post-operative period (3) 1 week and (4) 12 weeks. The appropriate treatment (pharmacology, monitoring, etc.) for each period is suggested, including the referral to a nerve specialist when appropriate.
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Rai KK, Shivakumar H, Sonar MD. Transient Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy for Setback of the Mandible: A Review of Incidence and Management. J Oral Maxillofac Surg 2008; 66:373-8. [DOI: 10.1016/j.joms.2006.06.257] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Accepted: 06/01/2006] [Indexed: 11/24/2022]
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Al-Bishri A, Dahlin L, Sunzel B, Rosenquist J. Systemic Betamethasone Accelerates Functional Recovery After a Crush Injury to Rat Sciatic Nerve. J Oral Maxillofac Surg 2005; 63:973-7. [PMID: 16003625 DOI: 10.1016/j.joms.2004.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of the study was to evaluate the effect of perioperatively systemically administered betamethasone on nerve recovery (within or outside a confined space) after induced nerve crush injury. MATERIALS AND METHODS The sciatic nerve of 40 adult Wistar rats was crushed. In half of the animals, the injured nerve was entrapped in a silicone tube to simulate the environment of a closed space, and in the other half the nerve was left to heal. Half of the rats in each group were treated with subcutaneous betamethasone (2 mg/kg body weight/day) during the first 24 hours, starting preoperatively, whereas the other half, the control animals, were given the same amount of physiological saline. All animals underwent preoperative and postoperative walking track analysis (toe spread [TS] and intermediate toe spread [ITS]) twice weekly for 6 weeks. RESULTS For nonconfined space groups, there was no significant difference between the 2 groups (P = .052 for ITS and P = .315 for TS) during the first 2 weeks. Starting from the end of the second week, animals treated with betamethasone recovered more rapidly than did the controls (P < .001) and continued to do so until the end of the observation period. In the confined space groups, there was a significant difference between the 2 groups for ITS (P < .001) and for TS (P < .05) during the first 2 weeks. The difference continued at almost the same level of significance (P = .001) for ITS, whereas for TS, the difference disappeared after the second week. CONCLUSIONS We conclude that short-term perioperative administration of betamethasone has a beneficial effect on the recovery of the injured rat sciatic nerve.
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Affiliation(s)
- Awwad Al-Bishri
- Department of Oral and Maxillofacial Surgery, University Hospital MAS and Faculty of Dentistry, Malmö University, Malmö, Sweden.
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Park JW, Qi WN, Cai Y, Nunley JA, Urbaniak JR, Chen LE. The effects of exogenous nitric oxide donor on motor functional recovery of reperfused peripheral nerve. J Hand Surg Am 2005; 30:519-27. [PMID: 15925162 DOI: 10.1016/j.jhsa.2004.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Revised: 11/01/2004] [Accepted: 11/05/2004] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the effects of the nitric oxide donor S-nitroso-N-acetylcysteine (SNAC) on motor functional recovery of reperfused rat sciatic nerve. METHODS Seventy-eight rats were divided into groups treated with SNAC (100 nmol/100 g/min), methylprednisolone 30 mg/kg/h for 15 minutes, 45-minute pause, 5.4 mg/kg/h for 1.5 h), and phosphate-buffered saline 0.2 mL/100 g/h). A 1-cm segment of sciatic nerve had 2 hours of ischemia and the results were evaluated after various reperfusion periods using a walking track test, muscle contractile testing, muscle weight, and histology. RESULTS During reperfusion there was a significant overall improvement in sciatic functional index measurement and isometric titanic contractile force for the SNAC-treated group compared with the methylprednisolone- and phosphate-buffered saline- treated groups. The SNAC group had significantly earlier improvement in the sciatic functional index measurement between days 7 and 28. Restoration of the contractile force and muscle weight of the extensor digitorum longus muscle began earlier in the SNAC group--after day 11--whereas the other 2 groups showed progressive atrophy until day 21, with a significant difference between the SNAC group and the other 2 groups. Histologic examination showed that SNAC-treated rats had less severe degeneration and earlier regeneration of axons than the others. Although methylprednisolone-treated rats showed earlier recovery than phosphate-buffered saline-treated rats in all parameters there were no significant differences between these 2 groups. CONCLUSIONS Supplementation of nitric oxide is effective in promoting motor functional recovery of the reperfused peripheral nerve and has potential to replace or augment steroids as therapeutic agents in treatment of nervous system ischemia/reperfusion injury.
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Affiliation(s)
- Jong Woong Park
- Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea
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Al-Bishri A, Rosenquist J, Sunzel B. On neurosensory disturbance after sagittal split osteotomy. J Oral Maxillofac Surg 2004; 62:1472-6. [PMID: 15573346 DOI: 10.1016/j.joms.2004.04.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this retrospective study was to assess the incidence of the neurosensory disturbance (NSD) after sagittal split osteotomy and evaluate NSD in relation to patient age, gender, satisfaction, and effect of steroids. PATIENTS AND METHODS Questionnaires were mailed to all patients (31 women, 19 men) who underwent bilateral sagittal split osteotomy between 1995 and 1999, at least 1 year after the operation. Patients were queried about perceived NSD in the distribution of both inferior alveolar and lingual nerves, duration of these changes, and any influence of these changes on their quality of life. RESULTS Eighty-six percent of the mailed questionnaires were returned and analyzed (27 women, 16 men). Eight patients with 10 affected sides (11.6% of sides) reported long lasting NSD corresponding to the distribution of the inferior alveolar nerve. NSD was reported in 16.7% of the operated sides in women, while 3% of the operated sides in the men had such changes. Fifty percent of the operated sides in patients over 40 years of age were affected. Steroid treatment seemed to decrease NSD. Four patients (9%) were not satisfied, but only 1 attributed the dissatisfaction to sensory impairment. CONCLUSION The incidence of NSD after sagittal split osteotomy increases in patients over the age of 40. Steroid regimen might be beneficial in reducing NSD after sagittal split osteotomy, although further investigation is required. The discomfort of the nerve damage seems outweighed by the result of function and esthetics.
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Affiliation(s)
- Awwad Al-Bishri
- Department of Oral and Maxillofacial Surgery, University Hospital MAS and Faculty of Dentistry, Malmö University, Sweden.
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Hiroi S, Tsukamoto Y, Sasaki F, Miki N, Taira E. Involvement of gicerin, a cell adhesion molecule, in development and regeneration of chick sciatic nerve. FEBS Lett 2003; 554:311-4. [PMID: 14623085 DOI: 10.1016/s0014-5793(03)01176-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We have examined the role of gicerin, an immunoglobulin superfamily cell adhesion molecule, in chick sciatic nerves during development and regeneration. Gicerin was expressed in the spinal cord, dorsal root ganglion (DRG) and sciatic nerves in embryos, but declined after hatching. Neurite extensions from explant cultures of the DRG were promoted on gicerin's ligands, which were inhibited by an anti-gicerin antibody. Furthermore, gicerin expression was upregulated in the regenerating sciatic nerves, DRG and dorsal horn of the spinal cord after injury to the sciatic nerve. These results indicate that gicerin might participate in the development and regeneration of sciatic nerves.
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Affiliation(s)
- Satoshi Hiroi
- Department of Veterinary Anatomy, Osaka Prefecture University, Graduate School of Agriculture and Biological Sciences, 1-1 Gakuencho, Sakai, Osaka 599-8531, Japan
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Shishido H, Kikuchi S, Heckman H, Myers RR. Dexamethasone decreases blood flow in normal nerves and dorsal root ganglia. Spine (Phila Pa 1976) 2002; 27:581-6. [PMID: 11884905 DOI: 10.1097/00007632-200203150-00005] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An experimental physiologic and histologic study of dexamethasone effects on peripheral nerves. OBJECTIVE To characterize the effect of topically applied 0.4% dexamethasone on acute changes in nerve blood flow and subsequent histologic changes in rat sciatic nerve fibers. SUMMARY OF BACKGROUND DATA Dexamethasone is an anti-inflammatory glucocorticoid used clinically to reduce the neural consequences of inflammation. Several reports of accidental injury to nerves after steroid injections have raised questions about the mechanisms involved in dexamethasone-induced neurotoxic injury. METHODS Nerve blood flow studies using a laser Doppler flowmeter were conducted in animals with stable temperature and arterial pressure. Dexamethasone 0.4%, 0.1 mL was applied topically to rat sciatic nerve in the following protocol groups: 1) nerve blood flow recording every 5 minutes for 30 minutes, and 2) initial nerve blood flow recording and repeat recording at 4 hours. Three additional animals had 30-minute nerve blood flow recordings in which normal saline was substituted for dexamethasone; these animals were used for control and to assure that the experimental preparation was viable throughout the observational period. Additional groups of two animals each received dexamethasone but were used only for neuropathologic observation at 2, 4, and 6 days after treatment. Neuropathologic studies were conducted on glutaraldehyde-fixed, plastic-embedded tissue. RESULTS Application of saline to the exposed sciatic nerves did not significantly change nerve blood flow from baseline values. Nerve blood flow values remained constant throughout the observational period. Dexamethasone, however, significantly reduced nerve blood flow in both the 30-minute and 4-hour groups. Some animals showed an initial transient increase in blood flow before nerve blood flow began to steadily decline to the final values reported. Neuropathologic changes were minimal and consisted only of edema and occasional subperineurial activation of Schwann cells. No demyelination or degeneration was seen. CONCLUSION Dexamethasone causes statistically significant reductions in normal nerve blood flow at 30 minutes and 4 hours after topical application; however, the reduction is on average below the threshold for causing ischemic changes in the structure of peripheral nerve fibers.
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Affiliation(s)
- Hiroaki Shishido
- Department of Orthopaedic Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan
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