Evaluation of the effectiveness of the application of plasma enriched with platelets in the process of facial nerve regeneration in rabbits

[M. F. Gardašević]

172 listova

Cilj: Cilj ove studije je bio da ispita efekte autologne plazme obogaćene trombocitima na proces neuroregeneracije povređenog facijalnog nerva. Metod: Eksperimentalnim životinjama indukovali smo povredu facijalnog nerva sekcijom. Ispitivanoj grupi naneta hirurška povreda facijalnog nerva tretirana je autolognom plazmom bogatom trombocitima (PRP). Funkcija nerva je ispitivana elektrofiziološkim metodama pre i nakon povrede (latenca, brzina nervne provodljivosti i amplituda ), a stepen vremenski zavisnog oporavka je procenjen na osnovu patohistoloških parametara (broj novostvorenih aksona, stepen zastupljenosti vezivnog tkiva, neovaskularizacija, broj Švanovih ćelija). Metodom subjektivne vizualizacije pokreta uške utvrdili smo vreme potrebno za oporavak nerva, i odredili korelaciju između brzine nervne provodljivosti i broja novostvorenih aksona. Rezultati: Rezultati dobijeni elektrofiziološkim merenjima kao i histološke analize pokazali su najbolje rezultate u grupi III gde smo koristili PRP. U odnosu na druge grupe koje nisu tretirane PRP, utvrđeno je da postoji značajno skraćenje vremenskog intervala potrebnog za oporavak nerva. Komparacijom dobijenih rezultata zaključili smo da je brzina nervne provodljivosti proporcionalna broju novostvorenih aksona i upućuje na uspešnu regeneraciju i reinervaciju po isteku šeste nedelje od rekonstrukcije povređenog facijalnog nerva. Predložena studija pruža podatke o svrsishodnosti primene faktora rasta u procesu nervne regeneracije i potencijalne kliničke primene čime bi se poboljšala perspektiva lečenja povređenog facijalnog nerva. Zaključak: Primena autologne plazme bogate trombocitima značajno skraćuje vreme neophodno za funkcionalni oporavak facijalnog nerva i mimične muskulature lica na modelu kunića nakon indukovane hirurške povrede.

The aim of this study was to investigate the effects of autologous platelet-rich plasma on the neuroregeneration process of an injured facial nerve. Material and Methods: In experimental animals, we induced facial nerve injury by dissection. A surgical injury to the facial nerve was treated with autologous platelet-rich plasma (PRP). Nerve function was examined by electrophysiological methods before and after injury (latency, nerve conduction velocity and amplitude), and the degree of time-depemdent recovery was assessed based on pathohistological parameters (number of newly created axons, degree of connective tissue representation, neovascularization, the number of Schwann cells). Using the method of subjective visualization of ear movements, we determined that the time required for recovery is correlated with the speed of nerve conduction and the number of newly created axons. Results: The results obtained by electrophysiological measurements as well as histological analyses showed the best results in group III where we used PRP. Compared to other groups that were not treated with PRP, it was found that there was a significant shortening of the time interval required for nerve recovery. By comparing the obtained results, we concluded that the speed of nerve conduction is proportional to the number of newly created axons and points to a successful regeneration and reinervation after the end of the sixth week from the reconstruction of the injured facial nerve. The proposed study provides data on the expediency of the application of growth factors in the process of nerve regeneration and its potential clinical application, which would improve the perspective of the treatment of the injured facial nerve. Conclusion: The administration of autologous platelet rich plasma significantly accelerates the functional recovery of the facial nerve and facial mimic muscles in a rabbit model after induced surgical injury.

plazma bogata trombocitima, facijalni nerv, faktori rasta, rekonstrukcija, neuroregeneracija, aksoni, Švanove ćelije, ekeltromioneurografija, histologija.

platelet rich plasma, facial nerve, growth factors, nerve regeneration, reconstruction, axons, Schwann cells, electromyoneurography, histology techniques.

617.5-089.844:616.314-089 616.314-089

Maksilovaficajna hirurgija

Tekst