| Purpose:The main purpose of this paper is to systematically evaluate the repair effect of stem cells for facial nerve defects.Methods:The researchers had collected all articles referring the regeneration effect of stem cells on facial nerves in animals published in the databases of Pubmed,The Cochrane Library,Web of Science,Embase,Scopus and CBM.Two professionals independently completed articles screening,data extraction and bias risk assessment.Review Manager(Version 5.3)and random-effects models or fixed-effects models were used for statistical analysis and the results were shown in the form of mean difference(MD)with a 95%CI.The sensitivity analysis was carried out by changing the analysis model and removing the original studies one by one.The funnel plot was used to evaluate the publication bias of the indicators whose number of original studies was greater than 10.The results of functional and histological evaluation of facial nerve were statistically analyzed.Results:A total of 4,614 articles were retrieved from these six databases,and fifteen of them with at least 719 animals were included in the Meta-analysis.For the score of vibrissae movement,the score of the stem cell group was significantly superior to that of the non-stem cell group(0.81,95%CI 0.25~1.37,P=0.005;I~2=86%,P<0.0001).And for the score of facial paralysis,the score of the stem cell group was also significantly higher(1.39,95%CI 1.20~1.58,P<0.00001;I~2=0,P=0.56).In terms of histological evaluation indicators,the density of myelinated fibers in stem cell group was higher than that of non-stem cell group(81.32,95%CI28.31~134.32,P=0.003;I~2=94%,P<0.00001),the difference of the diameter of myelinated fibers between stem cell group and non-stem cell group was of no statistical significance(1.25,95%CI-0.16~2.66,P=0.08;I~2=98%,P<0.00001),the thickness of myelin sheath in stem cell group was thicker than that of non-stem cell group(0.17,95%CI 0.10~0.23,P<0.00001;I~2=87%,P<0.00001),and the G ratio in stem cell grop was smaller than that of non-stem cell group(-0.06,95%CI-0.10~-0.02,P=0.002;I~2=41%,P=0.12).Sensitivity analysis results show that for the Meta-analysis results of each index,in addition to the results of fiber diameter,other analysis results are credible.The publication bias evaluation result show that there may be a degree of publication bias.Conclusion:Summarizing the analysis results and the discussion above,we believe that stem cells possess the potential of promoting facial nerve regeneration.However,to reach a definite conclusion,we need to explore this field further. |
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