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Hypoglossal-Facial Nerve Anastomosis in the Rabbits Using Laser Welding

Hwang, Kun MD, PhD*; Kim, Sun Goo MD, PhD*; Kim, Dae Joong PhD

doi: 10.1097/SAP.0b013e31815f12a5
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The aim of this study is to compare laser nerve welding of hypoglossal-facial nerve to microsurgical suturing and a result of immediate and delayed repair, and to evaluate the effectiveness of laser nerve welding in reanimation of facial paralysis of the rabbit models.

The first group of 5 rabbits underwent immediate hypoglossal-facial anastomosis (HFA) by microsurgical suturing and the second group of 5 rabbits by CO2 laser welding. The third group of 5 rabbits underwent delayed HFA by microsurgical suturing and the fourth group of 5 rabbits by laser nerve welding. The fifth group of 5 rabbits sustained intact hypoglossal and facial nerve as control. In all rabbits of the 4 different groups, cholera toxin subunit B (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative sixth week and in normal hypoglossal nerve in the 5 rabbits of control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically and the numbers were counted.

In the immediate HFA groups, CTb positive neurons were 1416 ± 118 in the laser welding group (n = 5) and 1429 ± 90 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.75). In the delayed HFA groups, CTb positive neurons were 1503 ± 66 in the laser welding group (n = 5) and 1207 ± 68 in the microsurgical suturing group (n = 5). Difference was significant (P = 0.009). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.208), but some significant difference was observed between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.016). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1970 ± 165. No dehiscence was seen on the laser welding site of nerve anastomosis in all the rabbits as re-exploration was done for injection of CTb.

This study shows that regeneration of the anastomosed hypoglossal-facial nerve was affected similarly by either laser welding or microsurgical suturing in immediate repair; however, the welding was more effective especially in delayed repair.

From the *Department of Plastic Surgery, Anatomy and the †Center for Advanced Medical Education by BK21 Project, Inha University College of Medicine, Incheon, Korea.

Received August 10, 2007 and accepted for publication, after revision, October 21, 2007.

This work was supported by a grant from Inha University (INHA Research Grant).

Reprints: Kun Hwang, MD, PhD, Department of Plastic Surgery, and Center for Advanced Medical Education by BK21 Project, Inha University College of Medicine, 7-206 Sinheung-dong, Jung-gu, Incheon, 400-711. Korea. E-mail: jokerhg@inha.ac.kr.

© 2008 Lippincott Williams & Wilkins, Inc.