Femoral nerve regeneration and its accuracy under different injury mechanisms

Facial reanimation with interposition nerve graft or masseter nerve transfer: a comparative retrospective study

Both interposition nerve grafts and masseter nerve transfers have been successfully used for facial reanimation after irreversible injuries to the cranial portion of the facial nerve. However, no comparative study of these two procedures has yet been reported. In this two-site, two-arm, retrospective case review study, 32 patients were included. Of these, 17 patients (eight men and nine women, mean age 42.1 years) underwent interposition nerve graft after tumor extirpation or trauma between 2003 and 2006 in the Ear Institute, School of Medicine, Shanghai Jiao Tong University, China, and 15 patients (six men and nine women, mean age 40.6 years) underwent masseter-to-facial nerve transfer after tumor extirpation or trauma between November 2010 and February 2016 in Shanghai Ninth People's Hospital, China. More patients achieved House-Brackmann III recovery after masseter nerve repair than interposition nerve graft repair (15/15 vs. 12/17). The mean oral commissure excursion ratio was also higher in patients who underwent masseter nerve transfer than in patients subjected to an interposition nerve graft. These findings suggest that masseter nerve transfer results in strong oral commissure excursion, avoiding obvious synkinesis, while an interposition nerve graft provides better resting symmetry. This study was approved by the Institutional Ethics Committee, Shanghai Ninth People's Hospital, China (approval No. SH9H-2019-T332-1) on December 12, 2019.

High-Definition Video System for Peripheral Neurorrhaphy in Rats

BACKGROUND

Although all microsurgeries are based on the use of surgical microscopes, several alternative magnification systems have shown promising results. Improvements in image quality facilitated the use of video systems in microsurgeries with safety and accuracy. The aim of this study was to evaluate the use of a low-cost, video-assisted magnification system in peripheral neurorrhaphy in rats.

METHODS

Twenty Wistar rats were randomly divided into 2 matched groups according to the magnification system used: the microscope group, with neurorrhaphy performed under a microscope with an image magnification of 40×; and the video system group, with the procedures performed under a video system composed of a high-definition Sony camcorder DCR-SR42 set to 52× magnification, macro lenses, 42-inch television, and a digital HDMI cable. We analyzed weight, nerve caliber, total surgery time, neurorrhaphy time, number of stitches, and number of axons in both ends (proximal and distal).

RESULTS

There were no significant differences between groups in weight, nerve caliber, or number of stitches. Neurorrhaphy under the video system took longer (video: 5.60 minutes; microscope: 3.20 minutes; P < .05). Number of axons was similar between groups, both in proximal and distal stumps.

CONCLUSION

It is possible to perform a peripheral neurorrhaphy in rats through video system magnification, but with a longer surgical time.