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Original Investigation |

Functional Recovery After Facial Nerve Cable Grafting in a Rodent Model

Marc H. Hohman, MD1,2; Ingrid J. Kleiss, MD2,3; Christopher J. Knox, BS2; Julie S. Weinberg, BA2; James T. Heaton, PhD4; Tessa A. Hadlock, MD1,2
[+] Author Affiliations
1Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts
2Division of Facial Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
3Department of Otolaryngology/Head and Neck Surgery, Radboud University, Nijmegen, the Netherlands
4Division of Laryngeal Surgery, Department of Surgery, Massachusetts General Hospital, Boston
JAMA Facial Plast Surg. 2014;16(1):20-24. doi:10.1001/jamafacial.2013.1431.
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Importance  Cable grafting is widely considered to be the preferred alternative to primary repair of the injured facial nerve; however, quantitative comparison of the 2 techniques has not been previously undertaken in a rodent model.

Objective  To establish functional recovery parameters after interposition autografting in a rodent facial nerve model.

Design, Setting, and Participants  Prospective randomized animal study at a tertiary care facial nerve center using 16 female Wistar Hannover rats.

Intervention  The experimental group received reversed autograft reconstruction of a 20-mm neural gap, and the control group received facial nerve transection and primary repair.

Main Outcome and Measure  Whisker excursion was measured weekly for 70 postoperative days using laser micrometers.

Results  The control group exhibited the most rapid recovery, with substantial return of whisker movement occurring during the third postoperative week. The experimental group demonstrated return of function beginning in the fourth postoperative week, eventually achieving a degree of function comparable to that of the control group by the sixth postoperative week (P = .68).

Conclusions and Relevance  Recovery of facial function after cable grafting seems to be slower than, but eventually similar to, recovery after primary neurorrhaphy in a rodent model. In the present study we have established a benchmark for recovery of whisker movement across a 20-mm rodent facial nerve gap, which will be used for comparison of different facial nerve gap bridging materials in future studies.

Level of Evidence  NA.

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Figure 1.
Rat Facial Nerve Anatomy and Corresponding Surgical Photographs Showing Representative Nerve Manipulations

A, Rat facial nerve anatomy. Dotted lines indicate sites of surgical photographs. B, Facial nerve main trunk after transection and primary suture repair just proximal to the pes anserinus. Blue surgical drape material was placed behind the nerve to enhance visual contrast. C, Neurorrhaphy of the reversed cable graft at the distal convergence, with the buccal and marginal mandibular branches shown running immediately adjacent to each other. Adapted from Henstrom et al6 and Hadlock et al [Plast Reconstr Surg 2010;125(1):99-109].

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Figure 2.
Measurement of Whisking Function in a Restrained Rat Using Laser Micrometers

The micrometer emitters and detectors are shown in pairs on the right and left sides of the rat, perpendicular to the horizontal whisking plane. Thin, light-weight tubes are threaded onto the right and left C1 whiskers, which are tracked by the micrometers to represent overall whisking function on each side, respectively.

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Figure 3.
Recovery of Function

A, Recovery of function as represented by amplitude of horizontal whisker excursion. B, Relative recovery as represented by the ratio of horizontal whisker movement amplitude on the operated (repaired) side to that on the unoperated (healthy) side. A value of 1 would represent symmetrical whisking amplitude. Data points indicate means, and error bars, standard deviations.

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