通过化学提取进行的脱细胞同种异体神经移植在临床上桥接整个面神经缺损方面取得了满意的效果。就分支单个树干和连接颞外部分的多个分支而言。然而,在面神经缺损的临床治疗中,同种异体供体有限。在这个实验中,我们暴露了六只恒河猴的左躯干和颞外段的多个分支,并解剖了25毫米的间隙,以构建完整的左神经缺损的猴子模型。六只猴子被随机分配到自体移植组或异种脱细胞神经移植组。在自体移植组中,使用自体同侧耳大神经立即桥接25毫米的整个面神经缺损,在异种脱细胞神经移植组中,这是使用具有主干分支的异种脱细胞神经移植物完成的。面部对称检查,神经肌肉电生理学,标记的神经元示踪剂的逆行运输,术后8个月的再生神经和靶肌肉的形态显示,猴子的面部在静止状态下表现为对称,在面部运动过程中略有不对称,他们可以积极地完全闭上眼睑。两组的面瘫恢复程度均达到House-BrackmannII级。记录了复合肌肉动作电位,每只猴子的口轮匝肌对手术侧的电刺激有反应。可以在受伤侧的面部核中检测到荧光金标记的神经元。免疫组织化学染色显示再生神经中丰富的神经丝200阳性轴突和可溶性蛋白100阳性雪旺细胞。通过亚甲蓝染色和透射电子显微镜观察到大量的中间移植物有髓轴突。一起来看,我们的数据表明,来自小型猪的异种脱细胞神经移植物对于修复恒河猴的整个面神经缺损是安全有效的,效果类似于自体神经移植。因此,如果没有其他方法,异种无细胞神经移植可能是桥接整个面神经缺损的合适选择。本研究获得了附属无锡市实验动物管理委员会和伦理审查委员会的批准。2南京医科大学人民医院,中国(批准号2018-D-1)于2018年3月15日。
Acellular nerve allografts conducted via chemical extraction have achieved satisfactory results in bridging whole facial nerve defects clinically, both in terms of branching a single trunk and in connecting multiple branches of an extratemporal segment. However, in the clinical treatment of facial nerve defects, allogeneic donors are limited. In this experiment, we exposed the left trunk and multiple branches of the extratemporal segment in six rhesus monkeys and dissected a gap of 25 mm to construct a monkey model of a whole left nerve defect. Six monkeys were randomly assigned to an autograft group or a xenogeneic acellular nerve graft group. In the autograft group, the 25-mm whole facial nerve defect was immediately bridged using an autogenous ipsilateral great auricular nerve, and in the xenogeneic acellular nerve graft group, this was done using a xenogeneic acellular nerve graft with trunk-branches. Examinations of facial symmetry, nerve-muscle electrophysiology, retrograde transport of labeled neuronal tracers, and morphology of the regenerated nerve and target muscle at 8 months postoperatively showed that the faces of the monkey appeared to be symmetrical in the static state and slightly asymmetrical during facial movement, and that they could actively close their eyelids completely. The degree of recovery from facial paralysis reached House-Brackmann grade II in both groups. Compound muscle action potentials were recorded and orbicularis oris muscles responded to electro-stimuli on the surgical side in each monkey. FluoroGold-labeled neurons could be detected in the facial nuclei on the injured side. Immunohistochemical staining showed abundant neurofilament-200-positive axons and soluble protein-100-positive Schwann cells in the regenerated nerves. A large number of mid-graft myelinated axons were observed via methylene blue staining and a transmission electron microscope. Taken together, our data indicate that xenogeneic acellular nerve grafts from minipigs are safe and effective for repairing whole facial nerve defects in rhesus monkeys, with an effect similar to that of autologous nerve transplantation. Thus, a xenogeneic acellular nerve graft may be a suitable choice for bridging a whole facial nerve defect if no other method is available. The study was approved by the Laboratory Animal Management Committee and the Ethics Review Committee of the Affiliated Wuxi No. 2 People\'s Hospital of Nanjing Medical University, China (approval No. 2018-D-1) on March 15, 2018.