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Effects of the Remaining and/or Spontaneously Regenerated Facial Axons After Hypoglossal-Facial Nerve Neurorrhaphy for Facial Paralysis.
Frontiers in Neurology ( IF 2.7 ) Pub Date : 2020-05-29 , DOI: 10.3389/fneur.2020.00413
Yuan Zhuang 1, 2 , Miao Ling 1, 2 , Zhen Li 1, 2 , Dezhi Li 2, 3 , Hong Wan 1, 2 , Michael Schumacher 4 , Song Liu 1, 2, 3, 4
Affiliation  

Background: The incidence of incomplete facial paralysis is now relatively higher in clinical practice, and surgical intervention is still desirable for patients with significant facial paralysis. However, the importance and usefulness of the remaining and/or spontaneously regenerated facial axons for regaining facial function when using hypoglossal-facial nerve (HN-FN) neurorrhaphy or other nerve-transferring methods to treat facial paralysis remain controversial. Objective: We designed a rat FN injury model with preservation of the anatomical structure followed by HN-FN side-to-side neurorrhaphy to investigate the effects of the remaining and/or spontaneously regenerated FN axons on restoration of facial function. Methods: After the evident return of facial function in 3 months following FN injury and HN-FN side-to-side neurorrhaphy, the FN was cross-sectioned again according to different ratios (0, 30, 70, and 100%) at the site rostral to the initial FN injury to retain, partially abolish, or completely abolish the spontaneously regenerated FN axons that had successfully reinnervated the paralyzed facial muscles. Then, FN function was assessed using clinical evaluation methods and electrophysiological examinations, as well as retrograde labeling and axonal counting assessments of the reconstructed nerve pathways. Results: The evaluations show that the remaining facial axons not only influenced the extent of regained function, such as facial symmetry, eye blinking activity, and vibrissae motion, but also had an impact on regeneration and innervation of hypoglossal motoneurons. Conclusion: Participation of remaining or spontaneously regenerated facial axons plays an important role in innervating paralyzed facial muscles by both facial and hypoglossal motoneurons, thus, reestablishing facial function.

中文翻译:

舌下-面部神经性神经性腹泻后剩余和/或自发再生的面部轴突对面部麻痹的影响。

背景:不完全性面瘫的发生率在临床实践中目前相对较高,对于严重的面瘫患者,仍需要手术干预。然而,当使用舌下面神经(HN-FN)神经性腹泻或其他神经转移方法治疗面部瘫痪时,剩余的和/或自发再生的面部轴突对于恢复面部功能的重要性和实用性仍存在争议。目的:我们设计了大鼠FN损伤模型,该模型保留了解剖结构,随后进行了HN-FN并排神经痛,以研究剩余和/或自发再生的FN轴突对面部功能恢复的影响。方法:FN损伤和HN-FN左右神经出血后3个月,面部功能明显恢复后,将FN再次按照与原始FN损伤相伴的鼻翼部位的不同比例(0、30、70和100%)进行横切,以保留,部分消除或完全消除已成功使神经支配的FN轴突。瘫痪的面部肌肉。然后,使用临床评估方法和电生理检查以及重建的神经通路的逆行标记和轴突计数评估来评估FN功能。结果:评估表明,剩余的面部轴突不仅影响恢复功能的程度,例如面部对称性,眨眼活动和触须运动,而且还影响舌下运动神经元的再生和神经支配。结论:
更新日期:2020-05-29
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