Histologic results of neuronal anastomosis of the microvascular latissimus dorsi transplant.
Latissimus dorsi transplants have little neuronal regenerative capacity without neuronal anastomosis. Histologic differences between transplants with and without neuronal anastomosis and two distinct types of neurotization are highlighted in this study. Eighteen patients after tumor resection and defect coverage with a latissimus dorsi transplant were examined preoperatively and postoperatively by means of a biopsy for histologic examination. The number of fascicles, degree of scarring, myelinization, and fibrosis were examined. All patients had a mean of 11.8 fascicles preoperatively. Patients without neuronal anastomosis showed an average of 5.0 fascicles, patients with nerve anastomosis to the cutaneous branches of the intercostal nerve showed an average of 6.2 fascicles, and patients with anastomosis to the thoracodorsalis nerve showed an average of 9.2 fascicles postoperatively. In cases of nerve anastomosis, a lesser degree of fibrosis was found, together with good myelinization. Neuronal reanastomosis led to more vital neuronal structures in the postoperative histologic specimen. The highest density of fascicles was found in the case of the well-vascularized thoracodorsalis nerve.
Schultes
G
G
Department of Oral and Maxillofacial Surgery, University Hospital Graz, Austria. guenter.schultes@kfunigraz.ac.at
Gaggl
A
A
Kärcher
H
H
Kleinert
R
R
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002921:Cicatrix; D005355:Fibrosis; D006801:Humans; D008833:Microcirculation; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation* / Q000473:pathology / Q000637:transplantation*