| Background and Objective:The nerve repair and functional reconstruction after peripheral nerve transection is still a challenging topic. At present traditional autologous nerve grafts still seem to be the best material to bridge peripheral nerve transection. However,this has several shortcomings,including limited source,aberrant regeneration,the removal of normal nerve and donor site morbidity consisting of scar formation,sensory loss and the formation of neuroma. There are some factors that have pushed several researchers to try to find new nerve regeneration conduits and nerve regeneration chambers able to lead regrowing axons from the proximal to the distal stump of a transected peripheral nerve. The history of conduits or chambers guiding nerve regeneration dates back to 1880,when Gllick tried decalcified bone grafts as conduits for axon regrowth. After this,several researchers have made many investigation for nonneural materials in order completely to replace autologous nerve grafts,the results were unsatisfactory. More recently,many researchers have transfered from improving microsurgical technique to seek nonneural materials to replace autologous nerve grafts,to ques the changes of cells,molecules and gene expression in the process of nerve regeneration and to investigate the role of activity factors in the microenvironment. In clinical,autologous fascia was usually used to repair some defects,but it has no investigation-related reports about the application of autologous fascia chambers inside putting muscle acellular basement membrane tubes and NGF repairing peripheral nerve transection. In the present study,a material suitable for the clinical repair of transected facial nerves was searched;the regenerative results of the transected facial nerves repaired by the autologous fascia nerve regeneration chambers were examined.Methods:1,The muscle acellular basement membrane tubes were prepared by using chemical extraction as Sondell M.2 The nerve regeneration chambers were made as following:After exposuring bilateral superior buccal branch of the facial nerve,masseteric fascias below the nerve were carefully detached,its length 10mm and broad 5mm. After the bilateral superior buccal branch of the facial nerve made a 8mm segment,the masseteric fascias were inversed and the proximal and distal stumps about 1mm were secured into either end of the inversion masseteric fascias by 11-0 nylon microsutures. Four sutures were used to obtain a opposite close nerve regeneration chamber.3 To divide into groups:According to the operative methods,there are three groups. A group is autologous fascia nerve regeneration chambers prefilled with muscle acellular basement membrane tubes. Autologous fascia nerve regeneration chambers prefilled with muscle acellular basement membrane tubes and NGF were used to repair an 8mm gap of the facial nerve as B group. Autologous nerve grafts in situ were used as a control group.4 Examinational method:cMAP,NAP and NCV were recorded by electromyography. The morphological recovery of the facial nerve regenerated was investigated by HE staining,transmission eletron microscope and image analysis following the implantation of the chambers.5 Statistical method:The software of SPSS 10.0 for Windows was used. The method is One-Way ANOVA(analysis of variance).Results:1,The difference between the experimental B group and the nerve autograft control group in the eletrophysiological indices had no statistical significance (P>0.05) at the end of 16 and 24th weeks. However,the difference between A group(without NGF) and B group(with NGF),or A group and the control C group in the eletrophysiological indices had statistical significance (P<0.05) at the end of 16 and 24th weeks. 2 Observation of light microscope:In the earlyperiod,A group has a fewer number and a less diameter of myelin nerve fiber than B group and C group. 16 weeks after operation,the regeneration nerve in the A group appeared less mature and number,and showed irregular and dispersive arrangement. On the...
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