title: Peripheral nerve elongation by laser Doppler flowmetry controlled expansion: morphological aspects.
abstract: Peripheral nerve elongation by a tissue expander may offer an alternative to nerve grafting in the management of segmental nerve loss. We investigated the morphological changes in peripheral nerve following slow nerve elongation by laser Doppler flowmetry controlled expansion in a rabbit sciatic nerve model. The animals were randomly assigned to one of four groups, with an expander volume of 0, 5, 10 or 15 cm3, respectively. An elongation of up to 40% was possible with preservation of clinical function. Nerve conduction velocity decreased in relation to elongation. Paranodal widening, followed by remyelination of the node, were early and constant morphological features. Demyelination and remyelination of whole internodes, and axonal degeneration occurred sporadically and did not correlate with elongation, rate of elongation or neurophysiological parameters. The model of laser Doppler flowmetry controlled nerve expansion provides a method for remodelling of myelin sheaths and lengthening of nerve fibers without axonal damage.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University Hospital Nijmegen, The Netherlands.
authors.forename: L P
authors.initials: LP
authors.lastname: van der Wey
authors.forename: A A
authors.initials: AA
authors.lastname: Gabreëls-Festen
authors.forename: M H
authors.initials: MH
authors.lastname: Merks
authors.forename: T W
authors.initials: TW
authors.lastname: Polder
authors.forename: D F
authors.initials: DF
authors.lastname: Stegeman
authors.forename: P H
authors.initials: PH
authors.lastname: Spauwen
authors.forename: F J
authors.initials: FJ
authors.lastname: Gabreëls
mesh_terms: D000818:Animals; D003711:Demyelinating Diseases; D017078:Laser-Doppler Flowmetry; D008959:Models, Neurological; D009186:Myelin Sheath / Q000502:physiology; D009410:Nerve Degeneration; D009431:Neural Conduction / Q000502:physiology*; D010525:Peripheral Nerves / Q000033:anatomy & histology / Q000502:physiology*; D011817:Rabbits; D012584:Sciatic Nerve / Q000033:anatomy & histology / Q000502:physiology; D015626:Tissue Expansion