|
Sign In to gain access to subscriptions and/or personal tools.
|
A Quantitative Morphological Comparison of Cat Lingual Nerve Repair Using Epineurial Sutures or Entubulation
G.R. Holland
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, 1011 N. University, Ann Arbor, Michigan 48109-1078
D. Andrade
Department of Restorative Dentistry, Faculty of Dentistry, University of Alberta, Edmonton, Alberta T6G 2N8, Canada
K.G. Smith
Department of Oral & Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, England
S. Lahl
Department of Restorative Dentistry, Faculty of Dentistry, University of Alberta, Edmonton, Alberta T6G 2N8, Canada
P.P. Robinson
Department of Oral & Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, England
E. Pehowich
Department of Restorative Dentistry, Faculty of Dentistry, University of Alberta, Edmonton, Alberta T6G 2N8, Canada
Since lingual nerves may be transected during a variety of oral surgical procedures, including third molar removal, we have investigated two possible methods of repair. Quantitative morphological observations were made on feline chorda tympani and lingual nerves proximal and distal to transection injuries repaired either by epineurial suturing or by insertion of the cut ends into a perforated silicon tube. Proximal to the repair, the most prominent difference was an increase in the number of myelinated axons in the lingual nerve following epineurial suturing but not entubulation. Proximal to the repair site, the number of non-myelinated axons increased in comparison with controls in both chorda tympani and lingual nerves after both procedures, though the difference was statistically significant only in the lingual nerve proximal to entubulation. Distal to the injury, both types of repair showed a reduction in the number, size, and sheath thickness of myelinated axons in comparison with unoperated controls, but the difference in numbers was statistically signficant only distal to repair by entubulation. The number of non-myelinated axons distal to the repair sites was much higher than that in controls, the difference being greater distal to entubulation repair. There were more axons per Remak bundle distal to entubulation repair than to epineurial suturing, suggesting, perhaps, that fewer axons would ultimately become myelinated. Though the morphological differences between the two repair techniques are not as striking as the parallel electrophysiological differences reported previously (Smith and Robinson, 1995a,b), they are consistent with them and support the conclusion that, for transected lingual and chorda tympani nerves, epineurial suturing is the preferred approach. Key words: lingual nerve, injury, oral surgery, taste.
REFERENCES
- Aitken JT (1949). The effect of peripheral connexions on the maturation of regenerating nerve fibres. J Anat 83:32-43.[Medline]
[Order article via Infotrieve]
- Aitken JT, Thomas PK (1962). Retrograde changes in fibre size following nerve section. J Anat 96:121-129.[Medline]
[Order article via Infotrieve]
- Ashur H., Vilner Y., Finsterbush A., Rousso M., Weinberg H., Devor M. (1987). Extent of fiber regeneration after peripheral nerve repair: silicone splint vs. suture, gap repair vs. graft. Exp Neurol 97:365-374.[CrossRef][Medline]
[Order article via Infotrieve]
- Beggs JL, Fischer DW, Shetter AG (1986). Comparative study of rat sciatic nerve microepineurial anastomoses made with carbon dioxide laser and suture techniques: Part 2. Neurosurg 18:266-269.[Medline]
[Order article via Infotrieve]
- Blackburn CW, Bramley PA (1989). Lingual nerve damage associated with the removal of lower third molars. Br Dent J 167:103-107.[CrossRef][Medline]
[Order article via Infotrieve]
- Cabaud HE, Rodkey WG, McCarroll HR Jr, Mutz SB, Niebauer JJ (1976). Epineurial and perineurial fascicular nerve repairs: A critical comparison. J Hand Surg 1:131-137.[Medline]
[Order article via Infotrieve]
- Fields RD, Ellisman MH (1986). Axons regenerated through silicone tube splices. II. Functional morphology. Exp Neurol 92:61-74.[CrossRef][Medline]
[Order article via Infotrieve]
- Fields RD, Le Beau JM, Longo FM, Ellisman MH (1989). Nerve regeneration through artificial tubular implants. Prog Neurobiol 33:87-134.[CrossRef][Medline]
[Order article via Infotrieve]
- Gibby WA, Koerber HR, Horch KW (1983). A quantitative evaluation of suture and tubulisation nerve repair techniques. J Neurosurg 58:574-579.[Medline]
[Order article via Infotrieve]
- Holland GR, Robinson PP (1990). The number and size of axons central and peripheral to inferior alveolar nerve injuries in the cat. J Anat 173:129-137.[Medline]
[Order article via Infotrieve]
- Holland GR, Robinson PP (1992). Axon populations in cat lingual and chorda tympani nerves. J Dent Res 71:1468-1472.
- Holland GR, Robinson PP, Smith KG, Pehowich E. (1996). A quantitative morphological study of the recovery of cat lingual nerves after transection or crushing. J Anat 188:289-297.
- Hudson AR, Hunter D., Kline DG, Bratton BR (1979). Histological studies of experimental interfascicular graft repairs. J Neurosurg 51:333-340.[Medline]
[Order article via Infotrieve]
- Jenq CB, Coggeshall RE (1985). Nerve regeneration through holey silicone tubes. Brain Res 361:233-241.[Medline]
[Order article via Infotrieve]
- Lubinska L. (1961). Demyelination and remyelination in the proximal parts of regenerated nerve fibers. J Comp Neurol 117:275-289.[Medline]
[Order article via Infotrieve]
- Mason DA (1988). Lingual nerve damage following lower third molar surgery. Int J Maxillofac Surg 17:290-294.
- Mayhew TM, Sharma AK (1984). Sampling schemes for estimating nerve fibre size. 1. Methods for nerve trunks of mixed fascicularity. J Anat 139:45-58.
- Merle M., Dellon AL, Campbell JN, Chang PS (1989). Complications from silicon-polymer intubulation of nerves. Microsurg 10:130-133.
- Morris JH, Hudson AR, Weddell G. (1972). A study of degeneration and regeneration in the divided sciatic nerve based on electron micrscopy. IV. Changes in fascicular microtopography, perineurium and endoneurial fibroblasts. Z Zellforsch Mikrosk Anat 124:165-203.[CrossRef][Medline]
[Order article via Infotrieve]
- Orgel MG, Terzis JK (1977). Epineurial vs. perineurial repair. Plast Reconstr Surg 60:80-91.
- Robinson PP (1989). The reinnervation 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.[CrossRef][Medline]
[Order article via Infotrieve]
- Rosen JM, Pham HN, Hentz VR (1989). Fascicular tubulization: a comparison of experimental nerve repair techniques in the cat. Ann Plast Surg 22:467-478.[CrossRef][Medline]
[Order article via Infotrieve]
- Sanders FK (1948). The thickness of the myelin sheaths of normal and regenerating peripheral nerve fibres. Proc R Soc Lond 135(B):323-357.
- Smith KG, Robinson PP (1995a). The reinnervation of the tongue and salivary glands after two methods of lingual nerve repair in the cat. Arch Oral Biol 40:373-383.[CrossRef][Medline]
[Order article via Infotrieve]
- Smith KG, Robinson PP (1995b). 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]
- von Arx DP, Simpson MT (1989). The effect of dexamethasone on neuropraxia following third molar surgery. Br J Oral Maxillofac Surg 27:477-480.[Medline]
[Order article via Infotrieve]
Journal of Dental Research, Vol. 75, No. 3,
942-948 (1996)
DOI: 10.1177/00220345960750031201
 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]
|
|
|
|
|
