title: Early and continued manual stimulation is required for long-term recovery after facial nerve injury.
abstract: BACKGROUND
  We previously have shown that manual stimulation (MS) of vibrissal muscles for 2 months after facial nerve injury in rats improves whisking and reduces motor end plate polyinnervation. Here, we seek to determine whether discontinuing or delaying MS after facial-facial anastomosis (FFA) leads to similar results.
  
  
  METHODS
  Rats were subjected to FFA and received MS for (1) 4 months (early and continued), (2) the first but not the last 2 months (discontinued), or (3) the last 2 months (delayed). Intact animals and those not receiving MS (no MS) were also examined.
  
  
  RESULTS
  Early and continued MS restored whisking amplitude to 43°, a value significantly higher compared with the discontinued, delayed, and no MS groups (32°, 24°, and 10°, respectively). Motor end plate polyinnervation occurred in all experimental groups but was significantly higher in the delayed group.
  
  
  CONCLUSIONS
  Early and continued MS results in better recovery than when it is either discontinued or delayed. Muscle Nerve 57: 100-106, 2018.
authors.affiliation: Department of Oto-Rhino-Laryngology, University of Cologne, Cologne, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Grosheva
authors.affiliation: Anatomical Institute I, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Köln, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Rink
authors.affiliation: Anatomical Institute I, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Köln, Germany.
authors.forename: Ramona
authors.initials: R
authors.lastname: Jansen
authors.affiliation: Department of Neurosurgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Cologne, Germany.
authors.forename: Habib
authors.initials: H
authors.lastname: Bendella
authors.affiliation: Department of Anatomy, Medical University of Varna, Varna, Bulgaria.
authors.forename: Stoyan P
authors.initials: SP
authors.lastname: Pavlov
authors.affiliation: Department of Anatomy, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Sarikcioglu
authors.affiliation: Anatomical Institute I, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Köln, Germany.
authors.forename: Doychin N
authors.initials: DN
authors.lastname: Angelov
authors.affiliation: Experimental and Regenerative Neuroscience, School of Biological Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Dunlop
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D020220:Facial Nerve Injuries / Q000628:therapy*; D005260:Female; D009045:Motor Endplate; D009121:Muscle Denervation; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D009416:Nerve Regeneration; D010812:Physical Stimulation; D051381:Rats; D017208:Rats, Wistar; D020127:Recovery of Function; D014738:Vibrissae / Q000294:innervation / Q000502:physiology
keywords: facial nerve; manual stimulation; recovery; surgical reconstruction; timing