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Original Article |

Quantitative Analysis of Muscle Histologic Method in Rodent Facial Nerve Injury

Tessa A. Hadlock, MD; Sang W. Kim, MD; Julie S. Weinberg, BA; Christopher J. Knox, BS; Marc H. Hohman, MD; James T. Heaton, PhD
JAMA Facial Plast Surg. 2013;15(2):141-146. doi:10.1001/jamafacial.2013.430.
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Objective  To describe denervation features of facial musculature following facial nerve injury in a rodent model.

Methods  Six Wistar-Hannover rats underwent unilateral transection and immediate repair of the facial nerve. After 8 weeks, muscular bundles consisting of dilator naris and levator labii superioris from both sides were analyzed for mean muscle cell diameter and the percentage of muscle cell cross-sectional area using image processing software. The atrophic features of facial muscles were quantified and compared with the contralateral, healthy side of the face.

Results  Weekly postoperative whisking assessment demonstrated the anticipated course of recovery. We observed significant differences between the normal side and the manipulated side, respectively, in the percentage of muscle specimen cross-sectional area attributable to muscle cell profiles (57% vs 29%; P = .006) and total fiber counts (1346 vs 794; P = .02). The mean cross-sectional area of individual muscle fibers was higher on the normal side (1129 vs 928 μm2; P = .39); however, this difference was statistically nonsignificant.

Conclusion  The objective, quantitative measures of muscle microstructure used in this report provide a valuable point of comparison for whisking function and electrophysiologic measures and can be used in future studies to assess muscle atrophic features associated with facial nerve injury and repair techniques.

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Figures

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Figure 1. After Masson trichrome staining (MTS) of tissue sections containing dilator naris muscle and levator labii superioris muscles, a sequential color deconvolution algorithm was applied, using Image J software, to measure muscle content of the specimens, fiber surface area, and fiber counts. A through C, This example of a control specimen at ×20 magnification after MTS demonstrated distinct 3-colored staining patterns. B, The entire specimen was then outlined with the Image J software.12 C, The muscle area (red stain) was selectively outlined through color-based image thresholding. D, The same specimen is shown at ×400 magnification. E, Individual muscle fiber staining is selectively outlined using the same thresholding approach.

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Figure 2. Mean maximal horizontal whisking amplitude at postrepair day 28. Recovery was significantly greater for the control side (58.5°) compared with the experimental side (17.1°). Limit lines indicate 95% confidence intervals.

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Figure 3. Stereotypical features of muscle atrophy seen in dilator naris muscle and levator labii superioris on the experimental side. A and B, Control side reveals healthy features of muscle fibers, including polygonal shape with overall uniform fiber size. C and D, Experimental side reveals decreased volume of muscle replaced by collagen (blue stain) and adipose tissue (white space with septation). Individual fibers display irregular round appearance (original magnification ×20 [A and C] and ×400 [B and D]).

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Figure 4. Quantitative comparison of muscle architectures. A and B, Statistically significant differences in muscle content and total fiber count were noted between the control and experimental sides. C, The mean cross-sectional area of individual muscle fibers was larger on the control side; however, this difference was not statistically significant. Limit lines indicate 95% confidence intervals.

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