End-to-Side Nerve Repair in Peripheral Nerve Injury

Beris, Alexandros E.; Lykissas, Marios G.; Korompilias, Anastasios V.; Mitsionis, G.

doi:10.1089/neu.2006.0165

Cited by 48 publications

(34 citation statements)

References 64 publications

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“…2,16,17,21,24 In the study with the largest number of patients published to date, the author reported good results * Axillary nerves or musculocutaneous nerves were reconstructed with different donor nerves. MN = median nerve; NA = not applicable; RN = radial nerve; SSN = suprascapular nerve; UN = ulnar nerve.…”

Section: Discussionmentioning

confidence: 97%

“…We use this method as our standard technique because studies with experimental models have indicated that the success rate of such sutures is high. 2,8,22 The existence of collateral sprouting of axons is well documented. Some authors have demonstrated in experimental studies that terminolateral nerve repair can be used without a surgical incision into the donor nerve's perineurium or epineurium.…”

Section: Discussionmentioning

confidence: 99%

“…One of the reasons for the active research into ETSN is an ongoing discussion about whether it is necessary to create a perineurial window to initiate collateral axon sprouting. 1,2,8,11 In addition, only a limited number of motor neurons have the capacity to send out collateral sprouts from intact axons. 6 Few clinical studies dealing with ETSN are available, and those that are represent mainly either case reports or reports involving only a few patients.…”

Section: ©Aans 2013mentioning

confidence: 99%

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End-to-side neurorrhaphy in brachial plexus reconstruction

Haninec¹,

Mencl²,

Kaiser³

2013

JNS

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Object. Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy.Methods. From 1999 to 2007, out of 791 reconstructed nerves in 441 patients treated for brachial plexus injury, the authors performed 21 axillary and 2 musculocutaneous nerve sutures onto the median, ulnar, or radial nerves. This technique was only performed in patients whose donor nerves, such as the thoracodorsal and medial pectoral nerves, which the authors generally use for repair of axillary and musculocutaneous nerves, respectively, were not available. In all patients, a perineurial suture was carried out after the creation of a perineurial window.Results. The overall success rate of the ETSN was 43.5%. Reinnervation of the deltoid muscle with axillary nerve suture was successful in 47.6% of the patients, but reinnervation of the biceps muscle was unsuccessful in the 2 patients undergoing musculocutaneous nerve repair.Conclusions. The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: ©Aans 2013mentioning

confidence: 99%

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End-to-side neurorrhaphy in brachial plexus reconstruction

Haninec¹,

Mencl²,

Kaiser³

2013

JNS

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“…15 While several articles demonstrate good results of end-toside neurorrhaphy in humans, 10,16 others do not suggest its indication. 17,18 For example, Fernandes et al 9 , after reviewing literature, affirmed the nonexistence of sufficient experimental or clinical evidence for the indication of end-to-side neurorrhaphy in humans. The same opinion is shared by Pienaar et al 4 , Pannicucci et al 11 and Beris et al 17 Due to the extremely favorable and tempting concepts of endto-side neurorrhaphy and of the significant difference of opinions in literature, the performance of new experimental studies with the addition of neurotrophic factors is imperative.…”

Section: Discussionmentioning

confidence: 99%

Avaliação histológica da neurorrafia término-lateral: estudo experimental em ratos

et al. 2011

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Objective: The aim of this study was to histologically compare the axonal sprouting after end-to-side neurorrhaphy with or without epineurotomy. Methods: twenty male Wistar rats were used, divided into two groups of 10 rats each. A 1.0cm segment of the tibial nerve E was dried and sutured on the opposite side, where it was sutured into the sciatic nerve D. In Group I, the suture was made directly in the epineurium and in Group II, epineurotomy was performed. After 4 weeks, histological evaluation was carried out of the transposed segment and the sciatic nerve distal to the suture. Results: the results showed a small number of

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“…[1][2][3][4][5][6] Functional motor and sensory reinnervation of target tissue was observed after such nerve repair in experimental mammals. [7][8][9][10][11][12][13][14][15][16] Also, several clinical case series suggest that some patients with extensive nerve injuries in the upper extremity, facial palsy, or neurinoma could benefit by such a treatment, although the results are quite unpredictable.…”

Section: Introductionmentioning

confidence: 99%

Influence of Breaching the Connective Sheaths of the Donor Nerve on Its Myelinated Sensory Axons and on Their Sprouting into the End-to-Side Coapted Nerve in the Rat

Kovačič

Žele²,

Tomšič³

et al. 2012

Journal of Neurotrauma

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The influence of breaching the connective sheaths of the donor sural nerve on axonal sprouting into the end-to-side coapted peroneal nerve was examined in the rat. In parallel, the effect of these procedures on the donor nerve was assessed. The sheaths of the donor nerve at the coaptation site were either left completely intact (group A) or they were breached by epineurial sutures (group B), an epineurial window (group C), or a perineurial window (group D). In group A, the compound action potential (CAP) of sensory axons was detected in *10% and 40% of the recipient nerves at 4 and 8 weeks, respectively, which was significantly less frequently than in group D at both recovery periods. In addition, the number of myelinated axons in the recipient nerve was significantly larger in group D than in other groups at 4 weeks. At 8 weeks, the number of axons in group A was only *15% of the axon numbers in other groups ( p < 0.05). Focal subepineurial degenerative changes in the donor nerves were only seen after 4 weeks, but not later. The average CAP area and the total number of myelinated axons in the donor nerves were not different among the experimental groups. In conclusion, myelinated sensory axons are able to penetrate the epiperineurium of donor nerves after end-to-side nerve coaption; however, their ingrowth into recipient nerves is significantly enhanced by breaching the epiperineurial sheets at the coaptation site. Breaching does not cause permanent injury to the donor nerve.

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End-to-Side Nerve Repair in Peripheral Nerve Injury

Cited by 48 publications

References 64 publications

End-to-side neurorrhaphy in brachial plexus reconstruction

End-to-side neurorrhaphy in brachial plexus reconstruction

Avaliação histológica da neurorrafia término-lateral: estudo experimental em ratos

Influence of Breaching the Connective Sheaths of the Donor Nerve on Its Myelinated Sensory Axons and on Their Sprouting into the End-to-Side Coapted Nerve in the Rat

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