For how long do denervated muscles in children retain the ability to regenerate?: Restoration of elbow flexion and shoulder function by partial nerve transfer in a child with long-standing poliomyelitis-like paralysis

Ochiai, Naoyuki; Matsumoto, Yukei; Hara, Yuki; Nishiura, Yasumasa; Murai, Shinji

doi:10.1016/j.jos.2018.10.014

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…[12][13][14] Although 24 months is generally accepted as a time limit for reinnervation procedures, 6 children seem to preserve neuromuscular regeneration capacity for a longer period as long as EMG shows the typical fibrillation potentials of denervated muscles. 15 Experimental studies have demonstrated that axonal regeneration is age-related with better results in younger individuals. 16 Physical therapy is crucial to reach optimal results following facial reanimation surgery.…”

Section: Discussionmentioning

confidence: 99%

Combined Sequential Bilateral Hypoglossal-to-facial and Masseter-to-facial Transfers for Bilateral Facial Paralysis

Morales‐Puebla

González-Otero

Moraleda

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Bilateral facial paralysis is a challenging situation requiring complex management. Surgical treatment can include nerve transfers, mainly masseter-to-facial, or muscle transfers, gracilis free flap, or temporalis transposition. Deciding on the surgical option depends on the duration of the paralysis and the feasibility of facial muscles. We present the case of a 10-year-old child with permanent bilateral facial paralysis after brainstem tumor surgery. The patient was treated with bilateral simultaneous hypoglossal-to-facial transfer followed by bilateral simultaneous masseter-to-facial 12 months later. After 23 months of follow-up and specific physical therapy, she has good and symmetric resting tone, complete eye closure, moderate bilateral smile excursion, mild lip pucker movement, and good oral competence. The combination of these two nerve transfers, when possible, gives the opportunity of restoring movement taking the best of each technique, with acceptable results and no significant clinical deficits in the donor sites.

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Section: Discussionmentioning

confidence: 99%

Combined Sequential Bilateral Hypoglossal-to-facial and Masseter-to-facial Transfers for Bilateral Facial Paralysis

Morales‐Puebla

González-Otero

Moraleda

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…Острый вялый миелит отличается от травмы нервов, акушерского паралича с повреждением плечевого сплетения тем, что в патологический процесс вовлекаются передние рога спинного мозга, что приводит к тяжелому повреждению мышц и нарушению функции конечности. При этом клинические проявления не всегда соответствуют поврежденному сегменту спинного мозга [15,19,34,35]. Наиболее характерно поражение мышц проксимальных отделов верхней конечности с нарушением функции плечевого сустава в 100 % случаев, локтевого сустава в 93 % случаев.…”

Section: клиника и диагностика острого вялого миелитаunclassified

“…По мнению N. Ochiai и соавт. (2019), в качестве донорского лучше выбирать нерв, который иннервирует узкую область миотома и способен восстановить силу реципиентной мышцы до 5 баллов уже на ранних сроках реиннервации [35].…”

Section: хирургическое лечениеunclassified

“…Ochiai и соавт. (2019) добились восстановления активного сгибания предплечья у ребенка после транспозиции нервов через 3 года 10 мес после ОВМ, однако последующая операция, выполненная через 6 мес (невротизация n. suprascapularis, n. axillaris), не привела к полному восстановлению функции плечевого сустава, что, по мнению авторов, свидетельствует о том, что у детей критическим сроком для успешной невротизации является срок 4 года после денервации мышц [35].…”

Section: сроки оперативного лечения и сроки реиннервации мышцunclassified

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Nerve transfer in children with acute flaccid myelitis for restoration of upper limb function (literature review)

Agranovich,

Komolkin

2024

Neuromuscular Diseases

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The term “acute flaccid myelitis” is used to describe a condition characterized by acute flaccid paralysis of the limb, as well as damage to the motor neurons of the spinal cord. The absence of specific treatment, severe neurological deficit that persists in 75–95 % of patients in the long term indicates its severity.The aim of the work is to describe acute flaccid myelitis in children, modern methods of treatment, and estimate the effectiveness of nerve transfers for restoration of the upper limb function.The search for publications was carried out in the PubMed/MEDLINE, Google Scholar databases from 2003 to 2022, and data from the US Centers for Disease Control and Prevention (https://www.cdc.gov) were used. There were analyzed surgical treatments of 57 children with paresis of the upper extremities due to AFM (105 nerve transfers). Restoration of shoulder function (neurotization of n. axillaris, n. suprascapularis) was performed in 57 (54.3 %) patients, elbow flexion (neurotization of n. musculocutaneus) in 37 (35.2 %), elbow extension in 9 (8.5 %) (neurotization of the branch of n. radialis to m. triceps brachii), fingers flexion in 1 (1 %) (neurotization of the n. interosseus anterior branch), fingers extension in 1 (1 %) (neurotization of n. interosseus posterior).The review demonstrated the effectiveness of nerve transfers in children with paresis of the upper extremities due to acute flaccid myelitis who were operated up to 1 year from the onset of the disease.

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“…After a nerve root is severed, the proximal stump is predisposed to axonal disintergration and apoptosis while the distal stump is inclined to form disorganized mass known as neuromas. Earlier reinnervation of a denervated limb results in better motor recovery, nevertheless, nerve regeneration is known to occur at only approximately 1 mm per day (Ochiai, Matsumoto, Hara, Nishiura, & Murai, ; Song et al, ). Less time to reinnervation, distance required for regenerating fibers to arrive at end organ, and higher proportion of aligned axons between stumps are three determinants in the improvement of motor outcomes (Simic et al, ; Ye, Shen, Feng, & Xu, ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

Qian

et al. 2020

Brain and Behavior

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Introduction: Peripheral neurotization, recently as a promising approach, has taken effect in recovering motor function after damage to a peripheral nerve root. Neural anastomosis comprised of nerve conduit and neurorrhaphy participates in the nerve reconstruction. Current literature lacks evidence supporting an individualized coaptation for rescue of locomotor loss in rat subjects with paraplegia secondary to peripheral nerve injury (PNI). Methods:This meta-analysis intends to qualify the specificity of gap-specific coaptation in treating a paralyzed limb following PNI. We used a highly sensitive search strategy to identify all published studies in multiple databases up to 1 May 2019. All identified trials were systematically evaluated using specific inclusion and exclusion criteria. Cochrane methodology was also applied to the results of this study.Results: Twelve studies, including 349 rat subjects, met eligibility criteria. For a medium nerve defect (0.5-3.0 cm), nerve conduit was more likely than neurorrhaphy to precipitate axon regeneration and improve motor outcome of the hemiplegic limb (OR = 3.61, 95% CI = 1.80, 7.26, p < .0003) at 3-month follow-up, whereas neurorrhaphy might take its place in promoting limb motor function in a small nerve gap (<0.5 cm) (OR = 0.48, 95% CI = 0.22, 1.07, p < .007). For a small nerve defect, nerve conduit still demonstrated visible effectiveness in recovery of limb motion albeit poorer than neurorrhaphy (OR = 1.50, 95% CI = 0.92, 2.47, p < .05). Conclusion: Selective neurotization facilitates motor regeneration after nerve transection, and advisable choice of neural coaptation can maximize functional outcome on an individual basis. K E Y W O R D S functional recovery, neurotization, neurotube, peripheral nerve injury, personalized coaptation

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For how long do denervated muscles in children retain the ability to regenerate?: Restoration of elbow flexion and shoulder function by partial nerve transfer in a child with long-standing poliomyelitis-like paralysis

Cited by 6 publications

References 14 publications

Combined Sequential Bilateral Hypoglossal-to-facial and Masseter-to-facial Transfers for Bilateral Facial Paralysis

Combined Sequential Bilateral Hypoglossal-to-facial and Masseter-to-facial Transfers for Bilateral Facial Paralysis

Nerve transfer in children with acute flaccid myelitis for restoration of upper limb function (literature review)

Efficacy evaluation of personalized coaptation in neurotization for motor deficit after peripheral nerve injury: A systematic review and meta‐analysis

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