| ObjectiveTo explore a more effective operation means to repair facial nerve defectson the basis of chemical acellular allogenic nerve.Methods40New Zealand rabbits of5-to-8month years old were randomly dividedinto A，B，Cand D group. The A group received the chemical acellular allogenicnerve and peripheral vein accompanying repair; The B group received thechemical acellular allogenic nerve without peripheral vein accompanying repair;The D group was repaired facial nerve defect with inverted autologous facialnerve graft; the C group received the self facial nerve in-situ anastomosis. Forthe A and B groups, an experimental model of defected upper buccal branchesof facial nerve was prepared for operation, which undergoes the chemicallyextracted nerve allograft and the suture between adjacent veins and nerve. TheC group received the in-situ anastomosis at the far and near ends in the sameplace after having facial nerve cut. The D group was repaired facial nerve defectwith inverted autologous facial nerve graft;After operation，the revascularizationobservation was performed at1months between each group. Three monthsafter operation,some tests such as visual observation, neuralelectrophysiological testing, image analysis of myelinated nerve fibers，electron microscope observation and muscle motor endplate staining and observation of right upper lip muscle in rabbits were done of the four groups. Itsdetect each index were analysand by SPSS17.0.ResultsThree months after operation，all rabbits had no death，no infection ofsurgical incision. A, B groups’ symmetry of facial expression was better than B,D. The degree of revascularization in the A group was significantly higher thanthat in the B group at1months. The conduction velocity of buccal branch was(56.21±10.53)m/s,(38.25±9.34)m/s,(61.11±9.71)m/s,(39.33±8.21)m/s in the four groups. After t test，A was significantly different from B(P <0.05),Group A’s postoperative effect was better than the other’s; A and C had nosignificant difference(P>0.05), the two groups had similar effects. C wassignificantly different from D(P <0.05),Group C’s postoperative effect was betterthan the other’s; B and D had no significant difference(P>0.05), the two groupshad similar effects. The number of myelinated nerve fibers near the anastomoticwas (18160.37±916.56) n/mm~2,(15307.26±932.64) n/mm~2,(18512.31±981.29)n/mm~2,(16211.37±956.91)n/mm~2in the four groups. After ttest，A was significantly different from B(P <0.05), Group A’s postoperativeeffect was better than the other’s, A and C had no significant difference (P>0.05), the two groups had similar effects. C was significantly different from D(P<0.05),Group C’s postoperative effect was better than the other’s; B and D hadno significant difference(P>0.05), the two groups had similar effects.The targetmuscle’s motor end plate count was (7.15±1.89) n/HP,(5.09±2.11)n/HP,(8.12±2.15) n/HP,(5.33±2.08) n/HP in the four groups.After t test，A wassignificantly different from B (P <0.05), Group A’s postoperative effect wasbetter than the other’s, A and C had no significant difference(P>0.05), the twogroups had similar effects. C was significantly different from D(P <0.05),GroupC’s postoperative effect was better than the other’s; B and D had no significantdifference(P>0.05), the two groups had similar effects..Group A and group C had similar electron microscope observation’s results,better than group BandD.The chemical acellular allogenic nerve with peripheral vein accompanying issuperior to the chemical acellular allogenic nerve without peripheral veinaccompanying in repairing facial nerve defects，similar to that self facial nervein-situ anastomosis.ConclusionsThe operation means to repair rabbit’s facial nerve defects using chemicalacellular allogenic nerve and peripheral vein accompanying shows apostoperative result similar to that self facial nerve in-situ anastomosis. |
