Regenerated nerve sprouting in the end to side neurorrhaphy

该过程中神经再生的机制尚不清楚。为了阐明这一点，我们在大鼠体内设计了完全无损伤的端侧粘连方法。用荧光染料(DiI)作为神经示踪剂，直接观察缝合部位再生的轴突。在完全无损伤模型中，神经在电物理和组织学上再生。通过对移植神经的间接电刺激，上臂左、右屈肌同时收缩。提示再生神经与受体神经之间以侧枝发芽的方式相连。即使在非损伤模型中，DiI也会将再生的神经染色到缝合部位之外。从吻合处的整个切面可以看到再生神经，也可以看到再生的神经从受体神经侧面发芽。根据这些结果，我们得出结论，即使在端侧吻合中，神经也是由供体神经发芽的侧支再生的。我们再次尝试了受体神经的端侧吻合，以避免切断原始神经。我们在端侧神经造影术的远端部分检查了几个侧面。在临床手术中，常采用面神经交叉移植和舌下神经-面神经吻合术相结合的方法。在这种情况下，两条神经向一块靶肌再生。因此，我们研究了在这种情况下再生的机制。根据这些结果，我们得出了在这种情况下存在双向神经方向项的可能性。似乎有必要通过改变再生项的时间来检查更多细节。

The mechanism of nerve regeneration in this procedure is still not clear. To elucidate it, we designed complete non-injurious end-to-side coaptation methods in rat. The regenerated axons at the coaptatoin site were observed directly using fluorescent dye(DiI) as a neural tracer. In a complete non-injury models, the nerve regenerated electrophysically and histologically. Both right and left flexor muscles of the upper arm contracted simultaneously by the indirect electric stimulation on the grafted nerve. It suggested that the regenerated nerve connected with the recipient nerve by collateral sprouting. DiI stained the regenerated nerve beyond the coaptation site even in a non-injury model. The regenerated nerve was observed from the whole section of the coaptation site and we could also observed the regenerated nerve sprouted from the recipient nerve collaterally. From these results, we conclude that even in the end-to-side neurorrhaphy the nerve regenerated by the collateral sprouting from the donor nerve.We tried again the end-to-side neurorrhaphy in the recipient nerve for clinical application of avoidance the cutting off the original nerve.We examined several-side at the distal portion of end-to-side neurorraphy. From these result, we confirmed that regeneration is possible at the distal portion of end-to-side neurorraphy.At the clinical operation, we often use the cross face nerve graft and the cross over operation by anastomosis at the hypoglossal-facial nerve, at the same time. In the cases, two nerves regenerate toward to one target musle. So, we investigated the mechanism of regeneration at such cases.From these results, we conclude the possibility of the double nerve direction term, in that cases.It seems necessary to examine more detail by changing time of regeneration term from the original nerve root.