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Pinto MMR, dos Santos DR, Bentes LGDB, Lemos RS, de Almeida NRC, Fernandes MRN, Braga JP, Somensi DN, de Barros RSM. Anatomical description of the extratemporal facial nerve under high-definition system: a microsurgical study in rats. Acta Cir Bras 2022; 37:e370803. [PMID: 36327397 PMCID: PMC9633007 DOI: 10.1590/acb370803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/25/2022] [Accepted: 07/22/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. METHODS Ten male Wistar rats (12-15 weeks old), without veterinary diseases, weighing 220-280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. RESULTS The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. CONCLUSIONS The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.
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Affiliation(s)
- Marcela Maria Rabelo Pinto
- MD, Fellow Master Degree. Universidade do Estado do Pará – Postgraduate Program in Surgery and Experimental Research Medicine – Department of Experimental Surgery – Belem (PA), Brazil
| | - Deivid Ramos dos Santos
- MD, Fellow Master Degree. Universidade do Estado do Pará – Postgraduate Program in Surgery and Experimental Research Medicine – Department of Experimental Surgery – Belem (PA), Brazil
| | | | - Rafael Silva Lemos
- Graduate student. Universidade do Estado do Pará – School of Medicine – Department of Experimental Surgery – Belém (PA), Brazil
| | | | | | - Joyce Pantoja Braga
- Graduate student. Universidade Federal do Pará – School of Medicine – Department of Experimental Surgery - Belém (PA), Brazil
| | - Danusa Neves Somensi
- MD. Universidade Federal do Pará – School of Medicine – Department of Neurology – Belém (PA), Brazil
| | - Rui Sergio Monteiro de Barros
- PhD, Associate Professor. Universidade Federal do Pará – School of Medicine – Department of Experimental Surgery – Belém (PA), Brazil
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Chacon MA, Echternacht SR, Leckenby JI. Outcome measures of facial nerve regeneration: A review of murine model systems. Ann Anat 2020; 227:151410. [DOI: 10.1016/j.aanat.2019.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022]
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Salomone R. Response to Bittner et al.: Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic paralysis. Head Neck 2019; 41:3740-3742. [DOI: 10.1002/hed.25900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Raquel Salomone
- Department of OtorhinolaryngologyUniversity of São Paulo Medical School São Paulo Brazil
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Pereira LV, Bento RF, Cruz DB, Marchi C, Salomone R, Oiticicca J, Costa MP, Haddad LA, Mingroni-Netto RC, Costa HJZR. Stem Cells from Human Exfoliated Deciduous Teeth (SHED) Differentiate in vivo and Promote Facial Nerve Regeneration. Cell Transplant 2018; 28:55-64. [PMID: 30380914 PMCID: PMC6322138 DOI: 10.1177/0963689718809090] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Post-traumatic lesions with transection of the facial nerve present limited functional outcome even after repair by gold-standard microsurgical techniques. Stem cell engraftment combined with surgical repair has been reported as a beneficial alternative. However, the best association between the source of stem cell and the nature of conduit, as well as the long-term postoperative cell viability are still matters of debate. We aimed to assess the functional and morphological effects of stem cells from human exfoliated deciduous teeth (SHED) in polyglycolic acid tube (PGAt) combined with autografting of rat facial nerve on repair after neurotmesis. The mandibular branch of rat facial nerve submitted to neurotmesis was repaired by autograft and PGAt filled with purified basement membrane matrix with or without SHED. Outcome variables were compound muscle action potential (CMAP) and axon morphometric. Animals from the SHED group had mean CMAP amplitudes and mean axonal diameters significantly higher than the control group (p < 0.001). Mean axonal densities were significantly higher in the control group (p = 0.004). The engrafted nerve segment resected 6 weeks after surgery presented cells of human origin that were positive for the Schwann cell marker (S100), indicating viability of transplanted SHED and a Schwann cell-like phenotype. We conclude that regeneration of the mandibular branch of the rat facial nerve was improved by SHED within PGAt. The stem cells integrated and remained viable in the neural tissue for 6 weeks since transplantation, and positive labeling for S100 Schwann-cell marker suggests cells initiated in vivo differentiation.
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Affiliation(s)
- Larissa Vilela Pereira
- 1 Department of Ophthalmology and Otolaryngology, University of Sao Paulo, School of Medicine, Brazil
| | - Ricardo Ferreira Bento
- 1 Department of Ophthalmology and Otolaryngology, University of Sao Paulo, School of Medicine, Brazil.,2 Medical Investigations Laboratory of Otolaryngology/LIM 32, University of São Paulo, Brazil
| | - Dayane B Cruz
- 3 Human Genome and Stem-Cell Research Center, Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, Brazil
| | - Cláudia Marchi
- 2 Medical Investigations Laboratory of Otolaryngology/LIM 32, University of São Paulo, Brazil
| | - Raquel Salomone
- 1 Department of Ophthalmology and Otolaryngology, University of Sao Paulo, School of Medicine, Brazil
| | - Jeanne Oiticicca
- 1 Department of Ophthalmology and Otolaryngology, University of Sao Paulo, School of Medicine, Brazil.,2 Medical Investigations Laboratory of Otolaryngology/LIM 32, University of São Paulo, Brazil
| | - Márcio Paulino Costa
- 4 Department of Plastic Surgery, University of São Paulo, School of Medicine, Brazil
| | - Luciana A Haddad
- 3 Human Genome and Stem-Cell Research Center, Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, Brazil
| | - Regina Célia Mingroni-Netto
- 3 Human Genome and Stem-Cell Research Center, Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, Brazil
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Kökten N, Eğilmez OK, Kalcıoğlu MT, Baran M, Ekici AID. Evaluation of the Possible Neurotoxic Effect of the Bone Cement on the Facial Nerve: An Experimental Study. Clin Exp Otorhinolaryngol 2018; 11:174-180. [PMID: 29587474 PMCID: PMC6102333 DOI: 10.21053/ceo.2017.00864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/24/2017] [Accepted: 01/09/2018] [Indexed: 12/21/2022] Open
Abstract
Objectives To investigate neurotoxic effect of bone cement (BC) on facial nerve by using electrophysiological and histopathological methods. Methods This study included 20 male albino Wistar rats, divided into four equal groups. Group A was designed as the control group, while group B was sham group. In the group C, BC solution was dropped onto the facial nerve trunks of rats and washed with physiological saline after 5 seconds. In the group D, BC solution was dropped onto the facial nerve trunks of rats and after allowing 5 minutes to dry, wounds were closed. Pre- and postoperative (on 4th week) evoked electromyography (EMG) measurements were done. For histopathological assessments, the rats were euthanized and tissue samples of facial nerve and surrounding areas were collected. Results According to the wave amplitude levels of evoked EMG, postoperative amplitude levels of group D were significantly decreased, compared to preoperative amplitude levels (P=0.043). We found no statistically significant difference in inflammation among the groups. In none of the groups, foreign body reaction and granulation tissue were not detected in any of the groups. In addition, degeneration in axon, myelin, or perineural nets was not detected in any of the groups. Conclusion This study results suggest that BC has no direct toxicity on facial nerve, while it has indirect effects, by decreasing amplitude. Therefore, we conclude that direct contact of BC with nerve should be avoided, and the area should be cleaned by aspiration or washing with physiological saline in case of contact.
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Affiliation(s)
- Numan Kökten
- Department of Otorhinolaryngology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Oğuz Kadir Eğilmez
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - M Tayyar Kalcıoğlu
- Department of Otorhinolaryngology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Baran
- Department of Physiology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - A Işın Doğan Ekici
- Department of Pathology, Yeditepe University, Faculty of Medicine, Istanbul, Turkey
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Salomone R, Jácomo AL, Nascimento SBD, Lezirovitz K, Hojaij FC, Costa HJZR, Bento RF. Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic facial paralysis. Head Neck 2018. [PMID: 29522265 DOI: 10.1002/hed.25122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies in invertebrates have taught us that early cell membrane regeneration is determinant for axonal recovery and survival after trauma. Many authors obtained extraordinary results in neural regeneration using polyethylene glycol fusion protocols, which also involved microsutures and antioxidants. METHODS Sixty rats were evaluated with functional and histological protocol after facial nerve neurotmesis. Groups A and B had their stumps coapted with microsuture after 24 hours of neurotmesis and groups C and D after 72 hours. In addition to the microstructure, groups B and D used the polyethylene glycol-fusion protocol for the modulation of the Ca+2 . RESULTS At the sixth week, the latency of group D and duration of group B was lower than groups A and C (P = .011). The axonal diameter of the groups that used polyethylene glycol-fusion was higher than those who did not use polyethylene glycol-fusion (P ≤ .001). CONCLUSION Although not providing a functional improvement, polyethylene glycol-fusion slowed down demyelination.
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Affiliation(s)
- Raquel Salomone
- Department of Otorhinolaryngology, University of São Paulo Medical School, São Paulo, Brazil
| | - Alfredo Luiz Jácomo
- Department of Surgery, Discipline of Human Structural Topography, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Karina Lezirovitz
- Department of Otorhinolaryngology, University of São Paulo Medical School, São Paulo, Brazil
| | - Flávio Carneiro Hojaij
- Department of Surgery, Discipline of Human Structural Topography, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Ricardo Ferreira Bento
- Department of Otorhinolaryngology, University of São Paulo Medical School, São Paulo, Brazil
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Eğilmez OK, Kökten N, Baran M, Kalcıoğlu MT, Doğan Ekici I, Tekin M. Electrophysiological and Histopathological Evaluation of Effects of Sodium-2 Mercaptoethanesulfonate Used for Middle Ear Surgery on Facial Nerve Functions. J Int Adv Otol 2017; 14:239-244. [PMID: 29283098 DOI: 10.5152/iao.2017.3888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Sodium-2-mercaptoethanesulfonate (MESNA) is widely used in medicine because of its antioxidant and mucolytic effects. In recent years, it has been used in otologic surgery. Because it cleaves disulfide bonds, it is used to easily dissect the epithelial matrix in cholesteatoma and atelectasis. In this study, we hypothesized that MESNA does not have any toxic effect on the facial nerve, and the effects of MESNA on the facial nerve were examined histologically and electrophysiologically. MATERIALS AND METHODS Twenty Wistar albino rats were used. Groups A and B were designated as the control and sham groups, respectively. The animals in groups C and D were administered 20% and 50% of MESNA solution, respectively, after the facial nerve was exposed in the parotid region. Electromyography (EMG) measurements were performed preoperatively and postoperatively at 4 weeks. The animals were subsequently euthanized; facial nerve samples were taken for histopathological examination. RESULTS When EMG parameters were compared within and between each group, preoperative and postoperative results were not statistically significantly different. Histopathological examination showed that MESNA did not cause any inflammation, granulation tissue, or foreign body reaction. CONCLUSION To the best of our knowledge, the effects of MESNA on facial nerve functions have not been investigated. In this study, the effects of MESNA after direct application to the facial nerve were examined electrophysiologically and histologically, and it was determined that MESNA did not cause any toxic effects. It was concluded that MESNA can, therefore, be safely used during middle ear surgery.
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Affiliation(s)
- Oğuz Kadir Eğilmez
- Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Numan Kökten
- Department of Otorhinolaryngology, İstanbul Medeniyet University School of Medicine, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Baran
- Department of Physiology, İstanbul Medeniyet University School of Medicine, İstanbul, Turkey
| | - M Tayyar Kalcıoğlu
- Department of Otorhinolaryngology, İstanbul Medeniyet University School of Medicine, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Işın Doğan Ekici
- Department of Pathology, Yeditepe University School of Medicine, İstanbul, Turkey
| | - Muhammet Tekin
- Department of Otorhinolaryngology, İstanbul Medeniyet University School of Medicine, Göztepe Training and Research Hospital, İstanbul, Turkey
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Mesenchymal Stem Cells Enhance Nerve Regeneration in a Rat Sciatic Nerve Repair and Hindlimb Transplant Model. Sci Rep 2016; 6:31306. [PMID: 27510321 PMCID: PMC4980673 DOI: 10.1038/srep31306] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/18/2016] [Indexed: 01/16/2023] Open
Abstract
This study investigates the efficacy of local and intravenous mesenchymal stem cell (MSC) administration to augment neuroregeneration in both a sciatic nerve cut-and-repair and rat hindlimb transplant model. Bone marrow-derived MSCs were harvested and purified from Brown-Norway (BN) rats. Sciatic nerve transections and repairs were performed in three groups of Lewis (LEW) rats: negative controls (n = 4), local MSCs (epineural) injection (n = 4), and systemic MSCs (intravenous) injection (n = 4). Syngeneic (LEW-LEW) (n = 4) and allogeneic (BN-LEW) (n = 4) hindlimb transplants were performed and assessed for neuroregeneration after local or systemic MSC treatment. Rats undergoing sciatic nerve cut-and-repair and treated with either local or systemic injection of MSCs had significant improvement in the speed of recovery of compound muscle action potential amplitudes and axon counts when compared with negative controls. Similarly, rats undergoing allogeneic hindlimb transplants treated with local injection of MSCs exhibited significantly increased axon counts. Similarly, systemic MSC treatment resulted in improved nerve regeneration following allogeneic hindlimb transplants. Systemic administration had a more pronounced effect on electromotor recovery while local injection was more effective at increasing fiber counts, suggesting different targets of action. Local and systemic MSC injections significantly improve the pace and degree of nerve regeneration after nerve injury and hindlimb transplantation.
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Nepomuceno AC, Politani EL, Silva EGD, Salomone R, Longo MVL, Salles AG, Faria JCMD, Gemperli R. Tibial and fibular nerves evaluation using intraoperative electromyography in rats. Acta Cir Bras 2016; 31:542-8. [DOI: 10.1590/s0102-865020160080000007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/21/2016] [Indexed: 01/06/2023] Open
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Bento RF, Salomone R, Nascimento SBD, Ferreira RJR, Silva CFD, Costa HJZR. Mandibular branch of the facial nerve in wistar rats: new experimental model to assess facial nerve regeneration. Int Arch Otorhinolaryngol 2014; 18:277-82. [PMID: 25992106 PMCID: PMC4297024 DOI: 10.1055/s-0034-1366977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/11/2013] [Indexed: 01/09/2023] Open
Abstract
Introduction The ideal animal model for nerve regeneration studies is the object of controversy, because all models described by the literature have advantages and disadvantages. Objective To describe the histologic and functional patterns of the mandibular branch of the facial nerve of Wistar rats to create a new experimental model of facial nerve regeneration. Methods Forty-two male rats were submitted to a nerve conduction test of the mandibular branch to obtain the compound muscle action potential. Twelve of these rats had the mandibular branch surgically removed and submitted to histologic analysis (number, partial density, and axonal diameter) of the proximal and distal segments. Results There was no statistically significant difference in the functional and histologic variables studied. Conclusion These new histologic and functional standards of the mandibular branch of the facial nerve of rats establish an objective, easy, and greatly reproducible model for future facial nerve regeneration studies.
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Affiliation(s)
- Ricardo Ferreira Bento
- Department of Ophthalmology and Otolaryngology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Raquel Salomone
- Department of Ophthalmology and Otolaryngology, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Ciro Ferreira da Silva
- Department of Cell and Developmental Biology, Universidade de São Paulo, São Paulo, SP, Brazil
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Salomone R, Bento RF, Costa HJZR, Azzi-Nogueira D, Ovando PC, Da-Silva CF, Zanatta DB, Strauss BE, Haddad LA. Bone marrow stem cells in facial nerve regeneration from isolated stumps. Muscle Nerve 2013; 48:423-9. [PMID: 23824709 DOI: 10.1002/mus.23768] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2012] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Severe lesions in the facial nerve may have extensive axonal loss and leave isolated stumps that impose technical difficulties for nerve grafting. METHODS We evaluated bone marrow stem cells (BMSC) in a silicone conduit for rat facial nerve regeneration from isolated stumps. Group A utilized empty silicone tubes; in groups B-D, the tube was filled with acellular gel; and, in groups C and D, undifferentiated BMSC (uBMSC) or Schwann-like cells differentiated from BMSC (dBMSC) were added, respectively. Compound muscle action potentials (CMAPs) were measured, and histology was evaluated. RESULTS Groups C and D had the highest CMAP amplitudes. Group C had shorter CMAP durations than groups A, B, and D. Distal axonal number and density were increased in group C compared with groups A and B. CONCLUSIONS Regeneration of the facial nerve was improved by both uBMSC and dBMSC in rats, yet uBMSC was associated with superior functional results.
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Affiliation(s)
- Raquel Salomone
- Department of Otorhinolaryngology, University of São Paulo Medical School, Avenida Dr. Enéas de Carvalho Aguiar, 155-6° andar, Bloco 6, CEP 05403-000, São Paulo, Brazil
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Costa HJZR, Bento RF, Salomone R, Azzi-Nogueira D, Zanatta DB, Paulino Costa M, da Silva CF, Strauss BE, Haddad LA. Mesenchymal bone marrow stem cells within polyglycolic acid tube observed in vivo after six weeks enhance facial nerve regeneration. Brain Res 2013; 1510:10-21. [PMID: 23542586 DOI: 10.1016/j.brainres.2013.03.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/04/2013] [Accepted: 03/18/2013] [Indexed: 12/15/2022]
Abstract
Autografting is the gold-standard method for facial nerve repair with tissue loss. Its association with high-quality scaffolds and cell implants has disclosed distinct experimental outcomes. The aim of this study was to evaluate the functional and histological effects of bone marrow stem cells (BMSC) combined with polyglycolic acid tube (PGAt) in autografted rat facial nerves. After neurotmesis of the mandibular branch of the rat facial nerve, surgical repair consisted of nerve autografting (groups A-E) contained in pGAT (groups B-E), filled with basement membrane matrix (groups C-E) with undifferentiated BMSC (group D) or Schwann-like cells that had differentiated from BMSC (group E). Axon morphometrics and an objective compound muscle action potentials (CMAP) analysis were conducted. Immunofluorescence assays were carried out with Schwann cell marker S100 and anti-β-galactosidase to label exogenous cells. Six weeks after surgery, animals from either cell-containing group had mean CMAP amplitudes significantly higher than control groups. Differently from other groups, facial nerves with Schwann-like cell implants had mean axonal densities within reference values. This same group had the highest mean axonal diameter in distal segments. We observed expression of the reporter gene lacZ in nerve cells in the graft and distally from it in groups D and E. Group-E cells had lacZ coexpressed with S100. In conclusion, regeneration of the facial nerve was improved by BMSC within PGAt in rats, yet Schwann-like cells were associated with superior effects. Accordingly, groups D and E had BMSC integrated in neural tissue with maintenance of former cell phenotype for six weeks.
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