Corneal Neurotization from the Supratrochlear Nerve with Sural Nerve Grafts

Bains, Robert; Elbaz, Uri; Zuker, Ronald M.; Ali, Asim; Borschel, Gregory H.

doi:10.1097/prs.0000000000000994

Cited by 80 publications

(70 citation statements)

References 8 publications

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“…The technique and principles of this strategy were developed in Toronto and reported by Elbaz et al 49 and Bains et al 50 to use a reversed sural nerve graft, coapted to the supratrochlear or supraorbital nerve and nerve fascicles sutured subconjunctivally to the perilimbal region. A transverse sub-brow incision was used to access the supratrochlear nerve, and end-to-side coaptation of the sural nerve graft was achieved by creating an epineural window.…”

Section: Introductionmentioning

confidence: 99%

“…Interpositional nerve graft techniques coapted to a healthy donor nerve: A–F, Elbaz et al ,49 Bains et al ,50 Weis et al ,59 Fung et al 89; and direct nerve transfer (G, Terzis et al ,48 Allevi et al ,53 Ting et al ,57 Leyngold et al— supraorbital nerve only56; H, Jacinto et al 54; I, Professor Gennaro (personal communication, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…In 2014, Elbaz et al 49 and Bains et al 50 reported outcomes using a reversed sural nerve graft, coapted to the supratrochlear or supraorbital nerve and nerve fascicles sutured subconjunctivally to the perilimbal region. They harvested the sural nerve proximally to distally using a nerve harvesting device placed around the nerve and passed distally, freeing the nerve from surrounding tissues 63.…”

Section: Introductionmentioning

confidence: 99%

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Update on corneal neurotisation

et al. 2018

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Corneal neurotisation describes surgical restoration of nerve growth into the cornea to restore corneal sensation and trophic function. It represents an exciting and effective emerging treatment for neurotrophic keratopathy. Techniques described to date involve either direct nerve transfer or an interpositional nerve graft coapted to a healthy donor nerve. We review the experience to date with particular emphasis on a detailed review of techniques, outcomes and current thoughts.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Update on corneal neurotisation

et al. 2018

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“…Surgical neurotization is a revolutionary treatment that directly addresses the etiology of NK to offer a potential cure. When successful, it facilitates corneal healing and prevention of corneal breakdown, while preserving vision and decreasing reliance on medications [5][6][7]. Additionally, it can transform patients with severe, irreversible corneal scarring into better corneal transplant candidates.…”

Section: Introductionmentioning

confidence: 99%

“…More recently, corneal neurotization utilizing a sural nerve graft interposed between the proximal donor SO or ST nerve and the affected limbus has been described ( Fig. 2) [6,7]. Restoration of corneal sensation has been reported following neurotization [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Anatomic characteristics of supraorbital and supratrochlear nerves relevant to their use in corneal neurotization

Domeshek

Hunter

Santosa

et al. 2018

Eye

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Background Corneal denervation can lead to opacification and blindness. A new treatment technique, surgical corneal neurotization, transfers healthy donor nerve, (most commonly contralateral supratrochlear or supraorbital) to the affected limbus to prevent corneal destruction and improve healing potential of the cornea following insult. We examine gross and histomorphometric anatomy of the supratrochlear and supraorbital nerves relevant to their use in corneal neurotization. Methods For each of nine adult cadaver heads, bilateral supraorbital and supratrochlear nerves were dissected from the supraorbital rim to the anterior hairline. The following data were recorded for each nerve: exit from the orbit through a notch versus foramen; horizontal distance from midline at the supraorbital rim; and distance from orbital exit to first branching point. Samples of all left supraorbital and supratrochlear nerves were obtained at the level of the supraorbital rim and at points 3 cm and 6 cm distally for histomorphometric analysis. Myelinated axon counts were determined for each sample. Results Four supraorbital foramina, 14 supraorbital notches, two supratrochlear foramina, and 15 supratrochlear notches were identified. Average supraorbital and supratrochlear distances to midline were 26.5 mm and 21 mm respectively. Average myelinated axon counts for both nerves were greater at the orbital rim (supraorbital: 6018, supratrochlear: 2533) than at 6 cm distally (supraorbital: 1621, supratrochlear: 1112). Conclusions Anatomic dissection shows relative close approximation of the supraorbital and supratrochlear nerves, with a high proportion of both nerves exiting the orbit through foramina. The supraorbital nerve at the orbital rim contains the greatest number of myelinated axons.

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Innovative surgical approach for trigeminal trophic syndrome: Successful healing of facial ulcers through cross‐face nerve grafts

Sun,

Li,

Zhu

et al. 2024

Head & Neck

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BackgroundTrigeminal trophic syndrome (TTS) is a rare condition caused by damage to the trigeminal nervous system, resulting in sensory disturbances and ulcers on the face. Treating TTS is complex and often requires medical or surgical intervention like flap reconstruction. However, there is limited research on surgical treatments for TTS ulcers.MethodsWe report the case of a 19‐year‐old man with TTS. We employed an innovative surgical technique involving dual cross‐face nerve grafts. In the initial procedure, corneal neuralization was accomplished using supraorbital and cross‐face infraorbital nerve graft. The subsequent operation utilized auricular composite tissue flap transplantation repair and cross‐face mental nerve graft.ResultsThis procedure led to rapid and sustained healing, as well as aesthetic improvement.ConclusionCross‐face nerve grafts is a promising tool in the treatment of refractory ulcers caused by diseases such as TTS.

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Corneal Neurotization from the Supratrochlear Nerve with Sural Nerve Grafts

Cited by 80 publications

References 8 publications

Update on corneal neurotisation

Update on corneal neurotisation

Anatomic characteristics of supraorbital and supratrochlear nerves relevant to their use in corneal neurotization

Innovative surgical approach for trigeminal trophic syndrome: Successful healing of facial ulcers through cross‐face nerve grafts

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