Improved Axon Diameter and Myelin Sheath Thickness in Facial Nerve Cable Grafts Wrapped in Temporoparietal Fascial Flaps

O'Sullivan, K L; Pap, Stephen; Megerian, Cliff A.; Li, Y; Sheffler, Lynn R.; Smith, Thomas W.; Wt, Lawrence

doi:10.1097/00000637-199805000-00006

Cited by 14 publications

(13 citation statements)

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“…25 Of course, the design of the studies, the kind of nerve transfer, and the animal model chosen also affect results. In agreement with results in a rabbit model and wrapped fascial nerve cable grafts in a rat model, 26 our use of the ischiatic nerve demonstrated that vascularized nerve transfers were superior to free non-vascularized transfers from a histologic point of view, even when nerves of VASCULARIZED VS. NON-VASCULARIZED NERVE TRANSFERS/SCHULTES ET AL.…”

Section: Discussionsupporting

confidence: 90%

Vascularized versus Non-Vascularized Nerve Transfers: Histologic Study in Rats

Schultes¹,

Gaggl²,

Kleinert³

et al. 2001

J reconstr Microsurg

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From the clinical point of view, the state of vascularized nerve transfers is clearly demonstrated in the literature. This study was carried out to elicit the basic histologic differences between vascularized and non-vascularized nerve transfers in an animal experiment. In 46 rats, the lateral femoral cutaneous nerve was resected, and an interposition with a free (n=23) ischiatic nerve transfer on one side and a vascularized (n=23) ischiatic nerve transfer on the other side was carried out. Three months postoperatively, the rats were sacrificed and 45 nerve transfers and 46 contralateral reference specimen probes were histologically evaluated. A lower degree of nerve fibrosis and vesicular degeneration of the myelin sheath were found in the vascularized nerve transfers, compared to the free non-vascularized transfers. The thickness of the myelin sheaths was less in the free transfers. From a histologic point of view, a lower degree of degenerative changes was seen in the vascularized nerves after transfer.

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Section: Discussionsupporting

confidence: 90%

Vascularized versus Non-Vascularized Nerve Transfers: Histologic Study in Rats

Schultes¹,

Gaggl²,

Kleinert³

et al. 2001

J reconstr Microsurg

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“…In addition, this flap has less donor site morbidity and does not stand out because it is behind the hair and does not require secondary procedures of defatting. Furthermore, some surgeons have reported its application as a gliding surface for the tendon to prevent tendon adhesion, and for nerve covering to promote neural recovery . In the current case, the patient maintained good function without neural readhesion after the neurolysis, and use of the TPF flap is a reliable method for reconstruction of the forearm with neural adhesion.…”

Section: Discussionmentioning

confidence: 68%

Application of free temporoparietal fascial flap for recurrent neural adhesion of superficial radial nerve—A case report

et al. 2015

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Because of its anatomical location, the superficial radial nerve is vulnerable to trauma as well as injury during various surgical procedures. Once the nerve adheres to surrounding scar tissue, radiating pain often occurs due to nerve traction caused by loss of smooth gliding. Since it has been reported that the success rate with neurolysis only is lower, additional preventive procedures for recurrent neural readhesion are recommended. In the current report, we describe our experience performing neurolysis followed by nerve coverage using a free temporoparietal fascial flap for recurrent neural adhesion of the superficial radial nerve. A 45-year-old male complained of motion pain of the left wrist and thumb joints caused by recurrent neural adhesion of the superficial radial nerve after a chain saw trauma and following multiple reconstructive procedures. The radiating pain completely disappeared after neurolysis performed by a previous surgeon; however, it recurred 4 weeks later. Four months after the previous neurolysis the patient underwent external neurolysis and covering of the nerve with a free temporoparietal fascial flap to prevent neural readhesion because local soft tissue could not be used due to the massive scar tissues on the forearm. One year after the secondary neurolysis, the symptoms of radiating pain during wrist and thumb motion were drastically improved. A free adipofascial flap such as a temporoparietal flap may be an option for prevention of neural readhesion after neurolysis of the superficial radial nerve in cases where a local flap cannot be used on the forearm.

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“…In a 1988 report by Kaplan, Gilbert, and the senior author, 41,42 use of the superficial temporal fascia to cover exposed tendons on the dorsum of the hand and open joints on the foot was described. O'Sullivan et al, 48 in 1998, reported the same healing attributes in nerve regeneration. The vascularized fascial flap not only enhances healing but facilitates a natural gliding Different strategies have been proposed to manage contour deficits in the face.…”

Section: Discussionmentioning

confidence: 84%