G. Ozcan et al., NERVE REGENERATION IN A BONY BED - VASCULARIZED VERSUS NONVASCULARIZED NERVE GRAFTS, Plastic and reconstructive surgery, 91(7), 1993, pp. 1322-1331
In a rabbit model, regeneration of the intratemporal facial nerve was
studied as vascularized and nonvascularized nerve grafts. Fifteen New
Zealand white rabbits weighing 4 to 4.5 kg were used. A 1-cm gap was c
reated in the intratemporal facial nerve. In the vascularized nerve gr
aft group (group 1), the facial nerve was repaired with a vascularized
median nerve graft (n = 6), while in the nonvascularized nerve graft
group (group 2), the median nerve was used as a nonvascularized graft
(n = 6). In group 3, the facial nerve gap was left unrepaired (n = 3).
At 3 months postoperatively, electrophysiologic testing, morphologic
nerve study, and morphometric muscle analysis were performed. Although
the mean numerical values of axonal counting, nerve conduction, and m
orphometric muscle study results were slightly better in the vasculari
zed nerve graft group, the differences between the two grafted groups
were not statistically significant (p > 0.05). Morphometric nerve anal
ysis, i. e., axon diameter and myelin sheath thickness, showed signifi
cant differences in nerve regeneration between the two groups (p < 0.0
5). These results suggest that a bony bed is not optimal for neovascul
arization of a nerve graft. We conclude that vascularized nerve grafts
are superior to nonvascularized nerve grafts when nerve regeneration
occurs in a bony recipient bed. This might be of clinical importance i
n the repair of facial nerve lesions within the temporal bone.