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Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures

Facial palsy (FP) is a debilitating nerve pathology. Cross Face Nerve Grafting (CFNG) describes a surgical technique that uses nerve grafts to reanimate the paralyzed face. The sural nerve has been shown to be a reliable nerve graft with little donor side morbidity. Therefore, we aimed to investigat...

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Autores principales: Kehrer, Andreas, Hollmann, Katharina S., Klein, Silvan M., Anker, Alexandra M., Tamm, Ernst R., Prantl, Lukas, Engelmann, Simon, Knoedler, Samuel, Knoedler, Leonard, Ruewe, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380239/
https://www.ncbi.nlm.nih.gov/pubmed/37510742
http://dx.doi.org/10.3390/jcm12144627
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author Kehrer, Andreas
Hollmann, Katharina S.
Klein, Silvan M.
Anker, Alexandra M.
Tamm, Ernst R.
Prantl, Lukas
Engelmann, Simon
Knoedler, Samuel
Knoedler, Leonard
Ruewe, Marc
author_facet Kehrer, Andreas
Hollmann, Katharina S.
Klein, Silvan M.
Anker, Alexandra M.
Tamm, Ernst R.
Prantl, Lukas
Engelmann, Simon
Knoedler, Samuel
Knoedler, Leonard
Ruewe, Marc
author_sort Kehrer, Andreas
collection PubMed
description Facial palsy (FP) is a debilitating nerve pathology. Cross Face Nerve Grafting (CFNG) describes a surgical technique that uses nerve grafts to reanimate the paralyzed face. The sural nerve has been shown to be a reliable nerve graft with little donor side morbidity. Therefore, we aimed to investigate the microanatomy of the sural nerve. Biopsies were obtained from 15 FP patients who underwent CFNG using sural nerve grafts. Histological cross-sections were fixated, stained with PPD, and digitized. Histomorphometry and a validated software-based axon quantification were conducted. The median age of the operated patients was 37 years (5–62 years). There was a significant difference in axonal capacity decrease towards the periphery when comparing proximal vs. distal biopsies (p = 0.047), while the side of nerve harvest showed no significant differences in nerve caliber (proximal p = 0.253, distal p = 0.506) and axonal capacity for proximal and distal biopsies (proximal p = 0.414, distal p = 0.922). Age did not correlate with axonal capacity (proximal: R = −0.201, p = 0.603; distal: R = 0.317, p = 0.292). These novel insights into the microanatomy of the sural nerve may help refine CFNG techniques and individualize FP patient treatment plans, ultimately improving overall patient outcomes.
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spelling pubmed-103802392023-07-29 Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures Kehrer, Andreas Hollmann, Katharina S. Klein, Silvan M. Anker, Alexandra M. Tamm, Ernst R. Prantl, Lukas Engelmann, Simon Knoedler, Samuel Knoedler, Leonard Ruewe, Marc J Clin Med Article Facial palsy (FP) is a debilitating nerve pathology. Cross Face Nerve Grafting (CFNG) describes a surgical technique that uses nerve grafts to reanimate the paralyzed face. The sural nerve has been shown to be a reliable nerve graft with little donor side morbidity. Therefore, we aimed to investigate the microanatomy of the sural nerve. Biopsies were obtained from 15 FP patients who underwent CFNG using sural nerve grafts. Histological cross-sections were fixated, stained with PPD, and digitized. Histomorphometry and a validated software-based axon quantification were conducted. The median age of the operated patients was 37 years (5–62 years). There was a significant difference in axonal capacity decrease towards the periphery when comparing proximal vs. distal biopsies (p = 0.047), while the side of nerve harvest showed no significant differences in nerve caliber (proximal p = 0.253, distal p = 0.506) and axonal capacity for proximal and distal biopsies (proximal p = 0.414, distal p = 0.922). Age did not correlate with axonal capacity (proximal: R = −0.201, p = 0.603; distal: R = 0.317, p = 0.292). These novel insights into the microanatomy of the sural nerve may help refine CFNG techniques and individualize FP patient treatment plans, ultimately improving overall patient outcomes. MDPI 2023-07-12 /pmc/articles/PMC10380239/ /pubmed/37510742 http://dx.doi.org/10.3390/jcm12144627 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kehrer, Andreas
Hollmann, Katharina S.
Klein, Silvan M.
Anker, Alexandra M.
Tamm, Ernst R.
Prantl, Lukas
Engelmann, Simon
Knoedler, Samuel
Knoedler, Leonard
Ruewe, Marc
Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title_full Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title_fullStr Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title_full_unstemmed Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title_short Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
title_sort histomorphometry of the sural nerve for use as a cfng in facial reanimation procedures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380239/
https://www.ncbi.nlm.nih.gov/pubmed/37510742
http://dx.doi.org/10.3390/jcm12144627
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