End-to-side neurorrhaphy with and without perineurium
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Data
1998-09-01
Autores
Viterbo, Fausto [UNESP]
Teixeira, Evandro [UNESP]
Hoshino, Katsumae [UNESP]
Padovani, Carlos Roberto [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Associação Paulista de Medicina (APM)
Resumo
OBJETIVOS: Comparar a neurorrafia término-lateral com epineuro versus sem epineuro. DESENHO: Foram operados 20 ratos. O nervo fibular foi seccionado e seu coto distal suturado na face lateral do nervo tibial. do lado direito nós removemos janela de epineuro e no lado esquerdo o epineuro foi deixado intacto. Depois de seis meses, os 14 animais sobreviventes foram submetidos a testes eletrofisiológicos, sacrificados e os nervos e músculos removidos para exames histológicos. O teste eletrofisiológico foi realizado mediante estímulo elétrico fornecido por um neuro-estimulador (LHM-110) com 2 milisegundos de duração, num modo repetido e 30 Hz. O estímulo foi aumentado progressivamente partindo de zero até atingir 1 volt. LOCAL: Faculdade de Medicina de Botucatu. RESULTADOS: No lado direito, os músculos que tiveram resposta positiva necessitaram uma média de 258,89 mv (±92,31) de estímulo elétrico para apresentar uma resposta e no lado esquerdo uma média de 298,34 mV (±139,32). O músculo tibial cranial apresentou peso médio para o lado direito de 0,47 g (±0,18) e para o lado esquerdo de 0,45 g (±0,15). O coto distal do nervo fibular apresentou uma média 310 fibras nervosas (±191,34) para o lado direito e 287,71 (±183,60) para o lado esquerdo. O nervo tibial acima da neurorrafia mostrou médias de 939,46 (±223,51) fibras nervosas para o lado direito e 959,46 (±327,48) para o lado esquerdo. O nervo tibial abaixo da neurorrafia mostrou médias de 935,17 (±298,65) fibras nervosas para o lado direito e 755,31 (±323,26) para o lado esquerdo. As fibras do músculo tibial cranial do lado direito apresentaram uma área média de 0,0162 (±0,008) m2 depois de 230 vezes de magnificação e 0,0152 (±0,0064) para as fibras do músculo tibial cranial do lado esquerdo. O aspecto histológico do músculo tibial cranial, tomando-se o normal como 100% foi de 78,21 (±20,75) para o lado direito e 82,14 (±15,89) para o lado esquerdo. A análise estatística (testetde Student) não mostrou diferenças (p>0,05) entre os lados esquerdo e direito para todas as variáveis. CONCLUSÕES: Ambas as neurorrafias (com e sem epineuro) não mostraram diferenças relacionadas aos aspectos morfológicos e eletrofisiológicos estudados.
OBJECTIVE: We compared end-to-side neurorraphy with and without the perineural sheath.METHOD: Twenty rats were used. The peroneal nerve was sectioned and the distal end was sutured to the lateral face of the tibial nerve. We removed the perineural sheath only on the right side, but not on the left side. The proximal end of the peroneal nerve was curved back approximately at a 100° angle and implanted into the adductor muscle. Six months later, the 14 surviving animals were submitted to electrophysiological tests, sacrificed, and the nerves and muscles were taken for histological exams.RESULTS: on the right side, the muscles that had positive response needed an average of 258.89 mV (±92.31) of electric stimulus and on the left side 298.34 mV (±139.32). The average weight of the tibial cranial muscles of the right side was 0.47 g (0.18) and for the left side 0.45 g (0.15). The distal end of the peroneal nerve showed averages of 310.29 (±191.34) nerve fibers on the right side and 287.71 (±183.60) on the left side. The tibial nerve above the neurorraphy showed averages of 939.46 (±223.51) nerve fibers on the right side and 959.46 (±327.48) on the left side. The tibial nerve below the neurorraphy showed averages of 935.17 (±298.65) nerve fibers on the right side and 755.31 (±323.26) on the left side. The average areas of the right tibial cranial muscles were 0.0162 m2 (±0.008), after 230 magnification, and 0.0152 m2 (0.0064) for the left tibial cranial muscles. The histological features of the tibial cranial muscles, taking normal as 100%, were 78.21 (±20.75) on the right side and 82.14 (±15.89) on the left side. The statistical analysis (Student's t test) did not reveal any difference (p>0.05) among right and left sides for all variables.CONCLUSION: The authors concluded that the two neurorraphies (with and without perineurium) did not show any difference regarding morphological and electrophysiological features studied.
OBJECTIVE: We compared end-to-side neurorraphy with and without the perineural sheath.METHOD: Twenty rats were used. The peroneal nerve was sectioned and the distal end was sutured to the lateral face of the tibial nerve. We removed the perineural sheath only on the right side, but not on the left side. The proximal end of the peroneal nerve was curved back approximately at a 100° angle and implanted into the adductor muscle. Six months later, the 14 surviving animals were submitted to electrophysiological tests, sacrificed, and the nerves and muscles were taken for histological exams.RESULTS: on the right side, the muscles that had positive response needed an average of 258.89 mV (±92.31) of electric stimulus and on the left side 298.34 mV (±139.32). The average weight of the tibial cranial muscles of the right side was 0.47 g (0.18) and for the left side 0.45 g (0.15). The distal end of the peroneal nerve showed averages of 310.29 (±191.34) nerve fibers on the right side and 287.71 (±183.60) on the left side. The tibial nerve above the neurorraphy showed averages of 939.46 (±223.51) nerve fibers on the right side and 959.46 (±327.48) on the left side. The tibial nerve below the neurorraphy showed averages of 935.17 (±298.65) nerve fibers on the right side and 755.31 (±323.26) on the left side. The average areas of the right tibial cranial muscles were 0.0162 m2 (±0.008), after 230 magnification, and 0.0152 m2 (0.0064) for the left tibial cranial muscles. The histological features of the tibial cranial muscles, taking normal as 100%, were 78.21 (±20.75) on the right side and 82.14 (±15.89) on the left side. The statistical analysis (Student's t test) did not reveal any difference (p>0.05) among right and left sides for all variables.CONCLUSION: The authors concluded that the two neurorraphies (with and without perineurium) did not show any difference regarding morphological and electrophysiological features studied.
Descrição
Palavras-chave
End-to-side neurorrhaphy, Microsurgery, Rats
Como citar
São Paulo Medical Journal. Associação Paulista de Medicina - APM, v. 116, n. 5, p. 1808-1814, 1998.