This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Smith, K.G. Articles by Robinson, P.P. Search for Related Content PubMed PubMed Citation Articles by Smith, K.G. Articles by Robinson, P.P. Social Bookmarking                         What's this?

The Re-innervation of the Tongue and Salivary Glands after Lingual Nerve Repair by Stretch, Sural Nerve Graft or Frozen Muscle Graft

Department of Oral & Maxillofacial Surgery, University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA, England

P.P. Robinson

Department of Oral & Maxillofacial Surgery, University of Sheffield, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA, England

The lingual nerve is sometimes injured during the surgical removal of impacted third molar teeth and may require repair. Removal of the damaged section of nerve prior to repair leaves a gap between the nerve ends, and we have investigated methods of closing the gap. The characteristics of regenerated fibers in the chorda tympani have been recorded in cats 24 weeks after the removal of a segment of lingual nerve and repair of the defect by three methods. The nerve gap was closed either by stretching the nerve ends together and repairing under tension, or by the insertion of a sural nerve graft or freeze-thawed muscle graft. The properties of gustatory, thermosensitive, and mechanosensitive units and the return of the vasomotor and secretomotor responses were investigated by electrophysiological techniques and the data from each of the repair groups compared with those obtained from a series of normal control animals. After each method of repair, the integrated whole-nerve activity recorded from the chorda tympani during gustatory or thermal stimulation of the tongue was reduced when compared with controls, but there was little significant difference between the repair groups. Recordings made from single units in the chorda tympani revealed that conduction velocities were faster after stretch repair than after sural nerve graft or frozen muscle graft. In addition, 48% of the units had developed into principally gustatory units after stretch repair, indicating a better level of recovery than in the graft groups, which contained 33% and 32%, respectively. The secretomotor responses were also significantly greater after stretch repair than in either of the graft groups or the controls, but there was no difference in the vasomotor responses. These results reveal that repair of a short gap in the lingual nerve by stretching the ends together is followed by better overall recovery than after grafting, but where a graft is used, a similar level of recovery results from use of a frozen muscle graft or a sural nerve graft.

Key Words: chorda tympani nerve • lingual nerve • nerve fibers • salivary gland • tongue

REFERENCES

• Bryan DJ, Miller RA, Costas PD, Wang KK, Seckel BR (1993). Immunocytochemistry of skeletal muscle basal lamina grafts in nerve regeneration. Plast Reconstr Surg 92:927-940. Clark WL, Trumble TE, Swiontkowski MF, Tencer AF (1992). Nerve tension and blood flow in a rat model of immediate and delayed repairs. J Hand Surg 17(A):677-687.
• Cohen MJ, Hagiwara S., Zotterman Y. (1955). The response spectrum of taste fibers in the cat: A single fiber analysis. Acta Physiol Scand 33:316-332.[Medline] [Order article via Infotrieve]
• Dykes RW, Terzis JK (1979). Reinnervation of glabrous skin in baboons: properties of cutaneous mechanoreceptors subsequent to nerve crush. J Neurophysiol 42:1461-1478. Emmelin N., Muren A., Stromblad R. (1957). The effect of anastomosis between the hypoglossa and chorda-lingual nerves on the supersensitivity of the dennervated submaxillary gland. Acta Physiol Scand 41:18-34.[Medline] [Order article via Infotrieve]
• Erici I., Uvnas B. (1952). Efferent and antidromic vasodilator impulses to the tongue in the chorda-lingual nerve of the cat. Acta Physiol Scand 25:10-14.[CrossRef][Medline] [Order article via Infotrieve]
• Erici I., Folkow B., Uvnas B. (1952). Sympathetic vasodilator nerves to the tongue of the cat. Acta Physiol Scand 25:1-9. Fawcett JW, Keynes RJ (1986). Muscle basal lamina: a new graft material for peripheral nerve repair. J Neurosurg 65:354-363. Foster E., Robinson PP (1994). The effect of nerve injury on the incidence and distribution of branched pulpal axons in the ferret. J Dent Res 73:1803-1810.
• Glasby MA (1990). Nerve growth in matrices of orientated muscle basement membrane. Clin Anat 3:161-182.[CrossRef]
• Glasby MA, Gschmeissner SG, Hitchcock RJI, Huang CL-H (1986a). The dependence of nerve regeneration through muscle grafts in the rat on the availability and orientation of basement membrane. J Neurocytol 15:497-510.[CrossRef][Medline] [Order article via Infotrieve]
• Glasby MA, Gschmeissner SG, Hitchcock RJ, Huang Cl-H, de Souza BA (1986b). A comparison of nerve regeneration through nerve and muscle grafts in rats. Neuroorthopedics 2:21-28.
• Glasby MA, Gschmeissner SG, Huang Cl-H, de Souza BA (1986c). Degenerated muscle grafts used for peripheral nerve repair in primates. J Hand Surg 11(B):347-351.[Abstract/Free Full Text]
• Glasby MA, Gschmeissner S., Hitchcock RJI, Huang CL-H (1986d). Regeneration of the sciatic nerve in rats. The effect of muscle basement membrane. J Bone Joint Surg 68(B):829-833.[Abstract/Free Full Text]
• Glasby MA, Gilmour JA, Gschmeissner SE, Hems TEJ, Myles LM (1990). The repair of large peripheral nerves using skeletal muscle autografts: a comparison with cable grafts in sheep femoral nerve. Br J Plast Surg 43:169-178.[CrossRef][Medline] [Order article via Infotrieve]
• Guttmann E., Sanders FK (1942). Functional recovery following nerve grafts and other types of nerve bridge. Brain 65:373-408. Hems TEJ, Glasby MA (1993). The limit of graft length in the experimental use of muscle grafts for nerve repair. J Hand Surg 18(B):165-170.[Abstract/Free Full Text]
• Hentz VR, Rosen JM, Xiao S.-J, McGill KC, Abraham G. (1993). The nerve gap dilemma: A comparison of nerves repaired end to end under tension with nerve grafts in a primate model. J Hand Surg 18(A):417-425.
• Horch KW (1979). Guidance of regrowing sensory axons after cutaneous nerve lesions in the cat. J Neurophysiol 42:1437-1449. Horch KW, Lisney SJW (1981). On the number and nature of regenerating myelinated axons after lesions of cutaneous nerves in the cat. J Physiol 313:275-286.[Abstract/Free Full Text]
• Jenq CB, Coggeshall RE (1987). Sciatic nerve regeneration after autologous sural nerve transplantation in the rat. Brain Res 406:52-61.[CrossRef][Medline] [Order article via Infotrieve]
• Kemplay SK, Garrett JR (1976). Effects of heterologous cross suture between postganglionic sympathetic and postganglionic parasympathetic nerve trunks of submandibular glands in cats. Cell Tissue Res 167:197-210. Lisney SJW (1981). Coupling between chorda tympani nerve fibres in the cat. 0 223:413-416.
• Lundborg G., Rydevik B. (1973). Effects of stretching the tibial nerve of the rabbit: a preliminary study of the intraneural circulation and the barrier function of the epineurium. J Bone Joint Surg 55(B):390-401.
• Millesi H., Berger A., Meissl G. (1972). Experimentelle untersuchungen zur heilung durchtrennter peripherer nerven. Chir Plastica 1:174-206.
• Miyamoto Y., Watari S., Tsuge K. (1979). Experimental studies on the effects of tension on intraneural microcirculation in sutured peripheral nerves. Plast Reconstr Surg 63:398-403. Nagaki J., Yamashita S., Sato M. (1964). Neural response of cat to taste stimuli of varying temperatures. Jpn J Physiol 14:67-89. Norris RW, Glasby MA, Gattuso JM, Bowden REM (1988). Peripheral nerve repair in humans using muscle autografts. J Bone Joint Surg 70(B):530-533.
• Oakley B. (1975). Receptive fields of cat taste fibres. Chem Senses Flav 1:431-442.[Abstract/Free Full Text]
• Pover CM, Lisney SJW (1988). An electrophysiological and histological study of myelinated axon regeneration after peripheral nerve injury and repair in the cat. J Neurol Sci 85:281-291.[CrossRef][Medline] [Order article via Infotrieve]
• Pover CM, Lisney SJW (1989). Influence of autograft size on peripheral nerve regeneration in cats. J Neurol Sci 90:179-185. Robinson PP (1988). The characteristics and regional distribution of afferent fibres in the chorda tympani of the cat. J Physiol 406:345-357.[Abstract/Free Full Text]
• Robinson PP (1989). The re-innervation of the tongue and salivary glands after lingual nerve injuries in cats. Brain Res 483:259-271.[CrossRef][Medline] [Order article via Infotrieve]
• Robinson PP (1992). The effect of injury on the properties of afferent fibres in the lingual nerve. Br J Oral Maxillofac Surg 30:39-45. Rodkey WG, Cabaud HE, McCarroll HR Jr (1980). Neurorrhaphy after loss of a nerve segment: comparison of epineurial suture under tension versus multiple nerve grafts. J Hand Surg 5:366-371.
• Smith KG, Robinson PP (1995). An experimental study of lingual nerve repair using epineurial suture or entubulation. Br J Oral Maxillofac Surg 33:211-219.[Medline] [Order article via Infotrieve]
• Stevens WG, Hall JD, Young VL, Weeks PM (1985). When should nerve gaps be grafted? An experimental study in rats. Plast Reconstr Surg 75:707-713.[CrossRef][Medline] [Order article via Infotrieve]
• Sunderland S. (1978). Nerves and nerve injuries. London: Churchill Livingstone.
• Terzis J., Faibisoff B., Williams H. (1975). The nerve gap. Suture under tension vs graft. Plast Reconstr Surg 56:166-170. Wong AYC, Scott JJA (1991). Functional recovery following direct or graft repair in nerve gaps in the rat. Exp Neurol 114:364-366.[Medline] [Order article via Infotrieve]

Journal of Dental Research, Vol. 74, No. 12, 1850-1860 (1995)
DOI: 10.1177/00220345950740120801


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G.R. Holland Experimental Trigeminal Nerve Injury Critical Reviews in Oral Biology & Medicine, January 1, 1996; 7(3): 237 - 258. [Abstract] [Full Text] [PDF]

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Smith, K.G. Articles by Robinson, P.P. Search for Related Content PubMed PubMed Citation Articles by Smith, K.G. Articles by Robinson, P.P. Social Bookmarking                         What's this?