The Correlations Of Trigeminal Nerve Demyelination With Pathological Changes Of Intraneural Microcirculation And Connective Tissue

Although substantive researches of histopathology have revealed that the trigeminal neuralgia (TN) attributes to the demyelination of the afflicted divisions of the trigeminal nerve, but the underlying mechanisms of demyelination are not clear. We aim to apply the pathological image analysis system to quantitively investigate the pathological changes of the intraneural microcirculation and connective tissues, of the diseased nerve divisions of the trigeminal nerves of the. patients afflicted the trigeminal neuralgia (TN), and the correlations of the two phenomenons with the demyelination respectively.The nerve specimens recruited from the resected third divisions of the trigeminal nerve, either of patients afflicted TN who were treated with the neuroectomy or of patients with oral carcinomas whose mandibles were resected partly, were divided into the TN group and the control group. Subsequently, the sections of those speciments were stained respectively with immunohistochemical staining technique and myelin staining technique, to mark the microvessels, myelination and connective tissues of the nerve fibres, furthermore, to be studied the morphological changes of the three intraneural components under the light microscope and the electron microscope, which followed by quantitive analysis with the image analysis system. Consequently, the measured indicators, including the ratio of the section square of the axon to the gross section square of the nerve fibre(Rl), the microvessel density(MVD)in the section of the nerve fibre, the ratio of the lumen square to the section square of the microvessel(R2) and the ratio of the square of the connective tissues to the gross section square of the nerve (R3), were analyzed detailedly with the SPSS 10.0 statistic analysis software package.The results of the statistic analysis were as the followings: 1. The Rl values in the TN group were statistically significantly lower than the control group (P=0.003), which showed that there were demyelination in the diseased divisions of the trigeminal nerve. 2. The MVD values and R2 values in the TN group were statistically significantly lower than the control group (.P=0.00l - 0.003), which showed that therewere microcirculation disturbances in the diseased divisions of the trigeminal nerve. 3. The R3 values in the TN group were statistically significantly higher than the control group (P=0.002), which showed that there were hyperplasia of the connective tissues in the diseased divisions of the trigeminal. 4. The lineal regression analyses of the F-test showed that there were statistically significantly positive lineal correlations between the MVD values ,R2 values and the R1 values respectively (P=0.000 .000), which indicated that the microcirculation disturbances in the diseased nerve fibres of the trigeminal nerve may contribute to the demyelinaton of them. 5. The lineal regression analyses of the F-test showed that there were statistically significantly negative lineal correlations between the R3 values and the Rl values (.P=0.030) , considering the Rl value correlate negatively to the extent of the demyelination, which then indicated that the hyperplasia of the connective tissues in the diseased nerve fibres of the trigeminal nerve may also contribute to the demyelinaton of them.As a result, these evidences reveal such valuable conclusions as the followings: 1. There are substantial microcirculation disturbances in the diseased divisions of the trigeminal nerve, which correlate significantly with the extent of dymyelination of them. 2. There are considerable hyperplasia of the connective tissues in the diseased divisions of the trigeminal nerve, which also correlate significantly with the extent of dymyelination of them. 3. The hyperplasia of the connective tissues may deteriorate the microcirculation disturbances in the diseased nerve divisions of the trigeminal nerves of patients afflicted TN. Furthermore, the two pathological changes may concomitantly destruct the blood-supply and nutrition of those nerve tissues, an...