EXPERIMENTS ON THE RESTORATION OF PARALYSED MUSCLES BY MEANS OF NERVE ANASTOMOSIS

Abstract

Restoration of voluntary co-ordinated movements after “nerve crossing,” first demonstrated by Flourens, has since been from time to time the subject of investigation. The conclusions of Flourens have been confirmed by Rawa, Stefani, Howell and Huber, Langley, and myself. A practical application in surgery was first suggested by Letievant, and within the past 12 years considerable development has taken place in this direction. During the past two years I have performed about 30 experiments on monkeys and dogs in order to investigate several points from the physiological standpoint. These experiments fall naturally into three groups. The first deals with the methods of cross union or anastomosis between the peripheral segment of a divided facial nerve and a suitable motor nerve in the neighbourhood. The second series of experiments deals with anastomosis in the fore limb of dogs, in order to investigate some aspects of the question not overtaken by previous work on this part of the subject. The third series deals with the brachial plexus, its functions, and the methods of anastomosis applied to it. The present communication is confined to an account of experiments with the facial nerve, of which there have been 10 performed. Of these 10, 6 were primary anastomosis and 4 secondary anastomosis, that is to say, in 6 the facial was cut, and its peripheral segment immediately anastomosed with the central segment of the substitute nerve, while in 4 the facial was cut, and left unattached for a period, precautions to prevent spontaneous reunion being taken, and then at the end of that period re-exposed, and united to the substitute nerve.