Abstract
The repair of injured or transected nerves is frequently encountered in head and neck surgery. Recently, CO2 lasers with milliwatt capability and micrometer spot sizes have been developed that may be used in nerve anastomosis. A comparative study was performed between microsuture and CO2 laser repair of transected sciatic nerves in rats. Nerve regeneration was measured in terms of morphology, electrophysiology, and function. Histologic studies revealed no difference in the size and number of regenerated axons, although there was less scar tissue formation at the anastomotic site with the laser repair. EMG and nerve conduction velocity were similar for the two repair methods. Functional recovery, as determined objectively using measurements of gait footprints, showed no difference between suture and laser repair. Laser-repaired nerves did have a higher dehiscence rate, although this problem can probably be prevented by splinting the rats postoperatively. However, laser repair was faster and simpler than suture repair and required less manipulation of the nerve. This study shows laser repair of peripheral nerves is possible with results comparable to conventional microsuture neurorrhaphy. Laser nerve anastomosis may be an effective alternative to suture nerve repair.
Highlights
The repair of injured or transected nerves is frequently encountered in head and neck surgery
Histologic studies revealed no difference in the size and number of regenerated axons, there was less scar tissue formationat the anastomoticsite with the laser repair
This study shows laser repair of peripheral nerves is possible with results comparable to conventional microsuture neurorrhaphy
Summary
The rat sciatic nerve model was used because objective behavioral measurements of the functional recovery of the rat sciatic nerve can be reliably quantified. The muscle and skin were closed in separate layers using 5-0 Dexon sutures. The film was fixed and dried tion of the sciatic nerve in rats can be reliably quantified to provide a permanent record for analysis. The “sciatic by measurements based on walking footprints, as first functional index” (SFI) was derived from eight meadescribed by de Medinaceli et al.[9] Footprint tracings sured parameters, reflecting footprint length and width, were obtained by dipping the hindpaws of the rats in toe spread, and stride length of normal sides and sides film developer solution and having the conditioned operated on. The SFI gives a normalized score, with rats walk down a narrow corridor lined with a strip of -100 being total loss of function and 0 being normal
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