title: Enhancement of facial nerve motoneuron regeneration through cross-face nerve grafts by adding end-to-side sensory axons.
abstract: BACKGROUND
  In unilateral facial palsy, cross-face nerve grafts are used for emotional facial reanimation. Facial nerve regeneration through the grafts takes several months, and the functional results are sometimes inadequate. Chronic denervation of the cross-face nerve graft results in incomplete nerve regeneration. The authors hypothesize that donor axons from regional sensory nerves will enhance facial motoneuron regeneration, improve axon regeneration, and improve the amplitude of facial muscle movement.
  
  
  METHODS
  In the rat model, a 30-mm nerve graft (right common peroneal nerve) was used as a cross-face nerve graft. The graft was coapted to the proximal stump of the transected right buccal branch of the facial nerve and the distal stumps of the transected left buccal and marginal mandibular branches. In one group, sensory occipital nerves were coapted end-to-side to the cross-face nerve graft. Regeneration of green fluorescent protein-positive axons was imaged in vivo in transgenic Thy1-green fluorescent protein rats, in which all neurons express green fluorescence. After 16 weeks, retrograde labeling of regenerated neurons and histomorphometric analysis of myelinated axons was performed. Functional outcomes were assessed with video analysis of whisker motion.
  
  
  RESULTS
  "Pathway protection" with sensory axons significantly enhanced motoneuron regeneration, as assessed by retrograde labeling, in vivo fluorescence imaging, and histomorphometry, and significantly improved whisker motion during video analysis.
  
  
  CONCLUSIONS
  Sensory pathway protection of cross-face nerve grafts counteracts chronic denervation in nerve grafts and improves regeneration and functional outcomes.
authors: Vienna, Austria; Toronto, Ontario, Canada; and Cologne, Germany From the Division of Plastic and Reconstructive Surgery, Medical University of Vienna; the Division of Plastic and Reconstructive Surgery and the Research Institute, Program in Neuroscience, The Hospital for Sick Children; the Division of Plastic and Reconstructive Surgery and the Institute of Biomaterials and Biomedical Engineering, University of Toronto; and the Anatomical Institute, University of Cologne.
authors: Eva
authors: E
authors: Placheta
authors: Matthew D
authors: MD
authors: Wood
authors: Christine
authors: C
authors: Lafontaine
authors: Edward H
authors: EH
authors: Liu
authors: J Michael
authors: JM
authors: Hendry
authors: Doychin N
authors: DN
authors: Angelov
authors: Manfred
authors: M
authors: Frey
authors: Tessa
authors: T
authors: Gordon
authors: Gregory H
authors: GH
authors: Borschel
mesh_terms: D000818:Animals; D001369:Axons / Q000502:physiology*; D019771:Axotomy; D001933:Brain Stem / Q000473:pathology; D005149:Facial Expression; D005152:Facial Muscles / Q000293:injuries; D005154:Facial Nerve / Q000502:physiology*; D005727:Ganglia, Spinal / Q000473:pathology; D017930:Genes, Reporter; D049452:Green Fluorescent Proteins / Q000032:analysis; D008340:Mandibular Nerve / Q000601:surgery; D009044:Motor Cortex / Q000502:physiology; D009046:Motor Neurons / Q000502:physiology; D009121:Muscle Denervation; D009413:Nerve Fibers, Myelinated / Q000648:ultrastructure; D009414:Nerve Growth Factors / Q000378:metabolism; D009416:Nerve Regeneration; D010543:Peroneal Nerve / Q000637:transplantation*; D051381:Rats; D017207:Rats, Sprague-Dawley; D055647:Rats, Transgenic; D012183:Retrograde Degeneration; D011984:Sensory Receptor Cells / Q000648:ultrastructure; D016042:Transplantation, Heterotopic; D014738:Vibrissae / Q000294:innervation
chemical_list: D009414:Nerve Growth Factors; D049452:Green Fluorescent Proteins
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