Stimulation of Trigeminal Afferents Improves Motor Recovery After Facial Nerve Injury: Functional, Electrophysiological and Morphological Proofs

123 Pages·2013·1.75 MB·English

by  Emmanouil Skouras

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Emmanouil Skouras,
Stoyan Pavlov,
Habib Bendella,
Doychin N. Angelov
Stimulation of
Trigeminal Afferents
Improves Motor
Recovery After Facial
Nerve Injury
Functional, Electrophysiological
and Morphological Proofs
With 15 figures
EmmanouilSkouras StoyanPavlov
DepartmentofTrauma,Hand, DepartmentofAnatomy,Histologyand
ReconstructiveSurgery Embryology
Universita¨tzuKo¨ln MedicalUniversityVarna
Ko¨ln Varna
Germany Bulgaria
HabibBendella
DoychinN.Angelov
InstitutIfu¨rAnatomie
Universita¨tzuKo¨ln
Ko¨ln
Germany
ISSN0301-5556 ISSN 2192-7065(electronic)
ISBN 978-3-642-33310-1 ISBN 978-3-642-33311-8(eBook)
DOI10.1007/978-3-642-33311-8
SpringerHeidelbergNewYorkDordrechtLondon
LibraryofCongressControlNumber:2012953091
#Springer-VerlagBerlinHeidelberg2013
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In Memoriam
In memory of our distinguished colleague and friend Prof. Dr. Ju¨rgen Koebke
(Department of Anatomy, University Hospital of Cologne, Germany) who died
suddenly on February 23, 2012. His father-like affection to students, sound
knowledge in anatomy and brilliant teaching will remain in the hearts of
thousands physicians and dentistsfor ever. Ju¨rgen Koebke’s endless enthusiasm
forbiomechanicalandsurgicalresearchinspiredhundredsofanatomyteachers,
abdominalandorthopedicsurgeons,andtraumatologistsworldwidefordecades.
v
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Abstract
Recovery of mimic function after facial nerve transection is poor: the successful
regrowthofaxotomizedmotoneuronstotheirtargetsiscompromisedby(1)poor
axonal navigation and excessive collateral branching, (2) abnormal exchange of
nerve impulses between adjacent regrowing axons, and (3) insufficient synaptic
inputtofacialmotoneurons.Asaresult,axotomizedmotoneuronsgethyperexcit-
ableandunabletodischarge.Sinceimprovementofgrowthconenavigationand
reduction of the ephaptic cross talk between axons turn out be very difficult, we
concentratedoureffortsonthethirddetrimentalcomponentandproposedthatan
intensificationofthetrigeminalinputtoaxotomizedelectrophysiologicallysilent
facialmotoneuronsmightimprovespecificityofreinnervation.Totestourhypoth-
esiswecomparedbehavioral,electrophysiological,andmorphologicalparameters
aftersinglereconstructivesurgeryonthefacialnerve(oritsbuccalbranch)with
those obtained after identical facial nerve surgery but combined with direct or
indirectstimulationoftheipsilateralinfraorbital(ION)nerve.Wefoundthatinall
cases, trigeminal stimulation was beneficial for the outcome by improving the
qualityoftargetreinnervationandrecoveryofvibrissalmotorperformance.
vii
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Acknowledgments
This work has been supported by the Jean Uhrmacher-Foundation, the Imhoff-
Foundation, and the Ko¨ln Fortune Programm. Special thanks to our colleagues
and friends Prof. Dr. Athanasia Alvanou, Prof. Dr. Sarah Dunlop, Dr. Maria
Grosheva, Dr. Marcin Ceynowa, Prof. Dr. Orlando Guntinas-Lichius, Dr. Peter
Igelmund, Privatdozent Dr. Andrey Irintchev, Prof. Dr. Katerina Kaidoglou,
Dr. Daniel Merkel, Dr. Anastas Popratiloff, Prof. Dr. Nektarios Sinis, and
Prof.Dr.MichaelStreppel.
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