Role of a muscle target organ on the regeneration of motor nerve fibres in long nerve grafts: A synopsis of experimental and clinical data

• Published in: Microsurgery Vol. 17; no. 2; pp. 80 - 88
• Main Authors: Frey, Manfred, Koller, Rupert, Liegl, Christian, Happak, Wolfgang, Gruber, Helmut
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York John Wiley & Sons, Inc 1996; Wiley-Liss
• Subjects: Anastomosis, Surgical; Animals; Biological and medical sciences; Cranial nerves. Peripheral nerves. Autonomic nervous system; Facial Muscles - innervation; Facial Muscles - surgery; Facial Nerve - surgery; Facial Nerve - ultrastructure; Facial Paralysis - surgery; Humans; Medical sciences; Microsurgery; Motor Neurons - physiology; Motor Neurons - ultrastructure; Muscle Fibers, Fast-Twitch - ultrastructure; Muscle Fibers, Slow-Twitch - ultrastructure; Muscle, Skeletal - innervation; Muscle, Skeletal - transplantation; Muscle, Skeletal - ultrastructure; Nerve Fibers - physiology; Nerve Fibers - ultrastructure; Nerve Fibers, Myelinated - ultrastructure; Nerve Regeneration; Neurosurgery; Peripheral Nerves - transplantation; Rabbits; Sheep; Sural Nerve - transplantation; Sural Nerve - ultrastructure; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thigh - innervation; Peripheral nerve; Motor system disorder; Rabbit; Autograft; Surgery; Microsurgery; Graft; ENT disease; Ungulata; Human; Nervous system diseases; Target organ; Facial paralysis; Facial nerve; Lagomorpha; Striated muscle; Pathology; Regeneration; Vertebrata; Mammalia; Cranial nerve disease; Treatment; Animal; Sheep; Artiodactyla; Technique; Morphometry
• ISSN: 0738-1085; 1098-2752
• DOI: 10.1002/(SICI)1098-2752(1996)17:2<80::AID-MICR2>3.0.CO;2-#

The importance of the muscle target organ as a promoting factor for nerve fibre regeneration in nerve grafts is still a subject of controversial discussion. In the last few years we published uniform results of experimental series in sheep and rabbits in which we investigated the biology of nerve fibre regeneration in long nerve autografts without connection to a target organ. Surprisingly, we found excellent regeneration of myelinated nerve fibres without the influence of a target organ through the whole length of the nerve graft, with an increase in the number of nerve fibres up to fourfold at the distal end. In the sheep series the additional contact with a muscle target organ for 6 months had a variable effect on the fibre population in the distal end of the nerve graft. The results of our planimetric analyses of nerve biopsies in patients with facial paralysis, who were treated by cross‐face nerve grafting and free muscle transplantation, are extremely divergent from the results of our experimental series. Instead of an increase, we found a decrease in number of regenerating nerve fibres arriving at the distal end of the cross‐face nerve graft down to 20%. Species‐specific differences in the biology of nerve regeneration are discussed, together with their implications for the complex clinical situation of nerve grafting with or without the influence of a target organ. © 1996 Wiley‐Liss, Inc.