Abstract
The lack of a clinically relevant animal models for research in facial nerve reconstruction is challenging. In this study, we investigated the surgical anatomy of the ovine sural nerve as a potential candidate for facial nerve reconstruction, and performed its histological quantitative analysis in comparison to the buccal branch (BB) of the facial nerve using cadaver and anesthetized sheep. The ovine sural nerve descended to the lower leg along the short saphenous vein. The length of the sural nerve was 14.3 ± 0.5 cm. The distance from the posterior edge of the lateral malleolus to the sural nerve was 7.8 ± 1.8 mm. The mean number of myelinated fibers in the sural nerve was significantly lower than that of the BB (2,311 ± 381vs. 5,022 ± 433, respectively. p = 0.003). The number of fascicles in the sural nerve was also significantly lower than in the BB (10.5 ± 1.7 vs. 21.3 ± 2.7, respectively. p = 0.007). The sural nerve was grafted to the BB with end-to-end neurorrhaphy under surgical microscopy in cadaver sheep. The surgical anatomy and the number of fascicles of the ovine sural nerve were similar of those reported in humans. The results suggest that the sural nerve can be successfully used for facial nerve reconstruction research in a clinically relevant ovine model.
Highlights
Many patients suffer from defects of the buccal branch of the facial nerve caused by malignant craniofacial tumors or various traumas, including burns
We have investigated the surgical anatomy of the ovine sural nerve and its related nerves (i.e., medial sural cutaneous nerve (MSCN), tibial, common fibular, and sciatic nerves), and compared the histological structures of these nerves to those of the buccal branch
The sural nerve, the medial sural cutaneous nerve (MSCN), and a communicating branch were found to be located under the gastrocnemius fascia, between the lateral and medial heads of the gastrocnemius, distal to the biceps femoris (Fig. 1C,D)
Summary
Many patients suffer from defects of the buccal branch of the facial nerve caused by malignant craniofacial tumors or various traumas, including burns. Autologous sural nerve grafting with an end-to-end neurorrhaphy technique to bridge defects of the buccal branch is the gold standard of surgical treatment for facial nerve reconstruction[1]. Most of the rodent studies have used the sciatic or great auricular nerves because these nerves are harvested and the rodent sural nerve is too short For this reason, a clinically-relevant large animal nerve graft model for facial nerve regeneration research is needed. The goal of this study was to establish an ovine model of facial nerve grafting for future research on facial nerve regeneration and reconstruction. We have investigated the surgical anatomy of the ovine sural nerve and its related nerves (i.e., medial sural cutaneous nerve (MSCN), tibial, common fibular, and sciatic nerves), and compared the histological structures of these nerves to those of the buccal branch
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