Open AccessFacial nerve repair utilizing intraoperative repair strategies
Author(s) -
Brown Brandon L.,
Sandelski Morgan M.,
Drejet Sarah M.,
Runge Elizabeth M.,
Shipchandler Taha Z.,
Jones Kathryn J.,
Walker Chandler L.
Publication year - 2020
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.411
Subject(s) - medicine , stimulation , fibrous joint , functional electrical stimulation , surgery , facial nerve , nerve repair , anesthesia , facial muscles , anatomy , peripheral nerve
Objectives To determine whether functional and anatomical outcomes following suture neurorrhaphy are improved by the addition of electrical stimulation with or without the addition of polyethylene glycol (PEG). Methods In a rat model of facial nerve injury, complete facial nerve transection and repair was performed via (a) suture neurorrhaphy alone, (b) neurorrhaphy with the addition of brief (30 minutes) intraoperative electrical stimulation, or (c) neurorrhaphy with the addition electrical stimulation and PEG. Functional recovery was assessed weekly for 16 weeks. At 16 weeks postoperatively, motoneuron survival, amount of regrowth, and specificity of regrowth were assessed by branch labeling and tissue analysis. Results The addition of brief intraoperative electrical stimulation improved all functional outcomes compared to suturing alone. The addition of PEG to electrical stimulation impaired this benefit. Motoneuron survival, amount of regrowth, and specificity of regrowth were unaltered at 16 weeks postoperative in all treatment groups. Conclusion The addition of brief intraoperative electrical stimulation to neurorrhaphy in this rodent model shows promising neurological benefit in the surgical repair of facial nerve injury. Level of Evidence Animal study.