Insulin-like growth factor-I promotes nerve regeneration through a nerve graft in an experimental model of facial paralysis

Among the pathological sequelae of facial paralysis is a Paralytic eye. Apa rt from the psychological and aesthetic deficits, facial paralysis if left untreated can lead to dryness, ulceration and eventual blindness. Although numerous restorative microsurgical approaches have been introduced to addre ss the sequelae of this problem, complete restoration of function to denerv ated facial muscles remains elusive. Utilizing the rat model of facial paralysis the present research has as an objective to examine a dual treatment approach. Specifically, this study co mbined the current microsurgical treatment of the cross-facial nerve graft with local administration of insulin-like growth factor I The efficacy of this combined approach (cross-facial nerve graft + IGF-I) w as assessed in the following ways: (a) behavior measurement of the blink re sponse and (b) histomorphometry light and electron microscopy of the entire nerve graft. These data will help provide insight into the restoration of facial muscle function after trauma and assist in the future development of more potent treatment strategies. The local administration of IGF-I (50 mu g/ml) to the cross-facial nerve gr aft was found to restore the blink response faster and to strengthen the de gree of eye closure. Light microscopy examination revealed that IGF-I signi ficantly enhanced axonal regeneration within a nerve graft (a 22 % increase in the mean number of axons), and increased the mean nerve fiber diameter and myelin thickness. Electron microscopy assessment of the nerve grafts de monstrated that the IGF-I treated grafts possessed a greater density of mic rotubules, which were evenly distributed within the axoplasm.