Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic facial paralysis

Abstract

Although not providing a functional improvement, polyethylene glycol-fusion slowed down demyelination.

Salomone et al did not induce PEG‐fusion repair of severed rat facial nerves

“…In this paper 2 cited by Salomone et al, 1 CMAPs were not recorded, but rather CAPs. More importantly, the authors 1 have misreported the previously published data for CAP recordings.…”

“…"After nerve section, prompt sealing of the multiple small openings of the cell membrane by structures attached to it, most of them being Ca +2 -dependent vesicles, would impair neural [sic] regeneration ( Figure 3A)." (Discussion) The papers referenced for this statement by Salomone et al 1 do not involve PEG-sealing and other papers cited in this letter 2,6-16 report that membrane sealing of axons with open ends after applying PEG does not impair regeneration by outgrowth. PEG does produce membrane sealing if applied to partially collapsed and/or vesicle-filled axonal ends [6][7][8][9]14 or cut ends that are not closely apposed.…”

“…Instead, the nerve is stimulated proximal to any PEG-fusion site and CAPs recorded from the nerve segment distal to any PEG-fusion repair site. CAP (much less CMAP) recordings have not been used as evidence of nerve viability as stated by Salomone et al, 1 but instead have been used as a measure of electrophysiological continuity of PEG-fused axons across a lesion site. The ability of distal nerve segments to elicit an action potential does not confound previously reported results.…”

“…Post-fusion CAP recordings are essential so that failed PEG-fusion neurorrhaphy technique can be altered until PEG-fusion success is reliably achieved. 9 Weeks after the surgery, the presence of CMAPs may be due to axons PEG-fused at the time of surgery or axons regenerating by outgrowth weeks after surgery, as is likely the case for Salomone et al 1 2. Conceptual misunderstandings a.…”

Response to Bittner et al.: Polyethylene glycol fusion associated with antioxidants: A new promise in the treatment of traumatic paralysis

“…The main objective of our study was to evaluate the use of PEG in late lesions, 9 different from what was done by Bittner et al in acute lesions. 2 For functional evaluation we used compound muscle action potential (CMAP), a method that has external validation and which in our opinion is more accurate than CAP used by Bittner et al 2 2 | DIFFERENT CONCEPTUAL UNDERSTANDINGS 2.1 | "After nerve section, prompt sealing of the multiple small openings of the cell membrane by structures attached to it, most of them being Ca 2+ -dependent vesicles, would impair neural regeneration ( Figure 3A)."…”