Sensory neurotization of muscle: past, present and future considerations

• Published in: Journal of plastic surgery and hand surgery Vol. 53; no. 1; pp. 31 - 36
• Main Authors: Kozusko, Steven D., Kaminsky, Alexander J., Boyd, Louisa C., Konofaos, Petros
• Format: Journal Article
• Language: English
• Published: Sweden Taylor & Francis 02.01.2019
• Subjects: Animals; denervation; Humans; Muscle Denervation; Muscle, Skeletal - innervation; Muscle, Skeletal - surgery; Muscular Atrophy - prevention & control; Nerve Transfer; neurotization; peripheral nerve; Sensory; trophic factor; trophic factor; denervation; peripheral nerve; Sensory; neurotization
• ISSN: 2000-656X; 2000-6764
• DOI: 10.1080/2000656X.2018.1523180

Research has shown that temporary innervation by a sensory neuron can provide trophic support to a denervated muscle and stave off muscular atrophy until motor neuron transfer is viable. This so called 'sensory protection' allows for improved outcomes when motor reinnervation able to occur. The theoretical benefit of sensory neurotization is hypothesized to maintain tissue architecture of the end organ due to tropic effects of stimulation. While the literature supports direct motor neurotization from 2 to 4 months post-injury, patient factors including the location of the injury and loss of nerve can preclude this therapeutic window. When direct neurotization is not possible, or there is a long distance to traverse for reinnervation, sensory neurotization may be beneficial. The theorized trophic stimulation enabling end organ architectural maintenance provided by sensory neurotization has been shown to allow for delayed direct motor neurotization without the irreversible sequelae of prolonged denervation. This is a review of the pathogenesis of nerve injury and a literature review of sensory neurotization. An analytical search of the literature in PubMed was performed in order to find articles pertinent to the topic of sensory neurotization, including experimental data from both animal models and case reports in humans.