Procena efikasnosti primene plazme obogaćene trombocitima u procesu regeneracije facijalnog nerva kunića
Sažetak
Uvod/Cilj. Povrede facijalnog nerva dovode do paralize mimičke muskulature lica, što je uslovljeno funkcionalnim poremećajima praćenim deformitetom različitog stepena, u zavisnosti od intenziteta i lokacije povrede. Hirurško lečenje je metoda izbora za lečenje povređenog nerva. Povrede u predelu parotidne lože se saniraju primenom direktnog neurošava u kombinaciji sa plazmom bogatom trombocitima (PBT). Metode. Eksperimentalna studija sprovedena je na 48 činčila zečeva (Orictolagus cuniculus) muškog pola, približno iste težine (2 500–3 000 gr), starosti između 3 i 4 meseca, u dva hirurška zahvata, u dva različita perioda: šest i deset nedelja nakon prvog hirurškog zahvata. Životinje su podeljene u četiri grupe: Grupa I (šav); Grupa II [šav i fibrinski lepak (FL)]; Grupa III (šav i PBT); Grupa IV (šav, FL i PBT). Svaka grupa imala je po dve podgrupe na osnovu trajanja eksperimenta (šest i deset nedelja). Deo diseciranog nerva u dužini od 5 mm podvrgnut je histološkoj analizi, kojom je određen i numerički izražen broj aksona i Švanovih ćelija. Stepen prisustva vezivnog tkiva i stepen neovaskularizacije prikazani su gradacijom histoloških uzoraka (vezivno tkivo 1-4, neovaskularizacija 1-3). Rezultati. Svi parametri regeneracije oštećenog nerva pokazali su da je značajno veća efikasnost regeneracije posle šest i deset nedelja intervencije postignuta u grupama lečenim PBT terapijom, sa ili bez upotrebe FL. Zaključak. Upotreba PBT i stimulatorno delovanje aktiviranih faktora rasta dovodi do regeneracije facijalnog nerva, u smislu replikacije Švanovih ćelija i broja aksona, sa visokim stepenom neovaskularizacije i minimalnom proliferacijom vezivnog tkiva, što histološki odgovara zdravom nervu.
Reference
1. Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve 1990; 13(9): 771‒84.
2. Jović N. Facial paralysis: etiology, diagnosis and treatment. Belgrade: Vojnomedicinska Akademija; 2004. (Serbian)
3. Klintworth N, Zenk J, Koch M, Iro H. Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function. Laryngoscope 2010; 120(3): 484‒90.
4. Asma A, Marina MB, Mazita A, Fadzilah I, Mazlina S, Saim L. Iatrogenic facial nerve palsy: lessons to learn. Singapore Med J 2009; 50(12): 1154‒7.
5. Davis RE, Telischi FF. Traumatic facial nerve injuries: review of diagnosis and treatment. J Craniomaxillofac Trauma 1995; 1(3): 30‒41.
6. Gordin EA, Daniero JJ, Krein H, Boon MS. Parotid gland trauma. Facial Plast Surg 2010; 26(6): 504‒10.
7. Gierek T, Majzel K, Slaska-Kaspera A, Gwóźdź-Jezierska M. The results of surgical treatment of the facial nerve paralysis. Otolaryngol Pol 2007; 61(4): 383‒6. (Polish)
8. Gavron JP, Clemis JD. Hypoglossal-facial nerve anastomosis: a review of forty cases caused by facial nerve injuries in the posterior fossa. Laryngoscope 1984; 94(11): 1447‒50.
9. Conley J, Baker DC. Hypoglossal-facial nerve anastomosis for reinnervation of the paralyzed face. Plast Reconstr Surg 1979; 63(1): 63‒72.
10. Messora MR, Hitomi Nagata MJ, Chaves Furlaneto FA, Menegati Dornelles RC, Mogami Bomfim SR, Tatiana Miranda Deliberador, et al. A standardized research protocol for platelet-rich plasma (PRP) preparation in rats. RSBO 2011; 8(3): 299‒304.
11. Ornelas L, Padilla L, Di Silvio M, Schalch P, Esperante S, Infante RL, et al. Fibrin glue: an alternative technique for nerve coaptation--Part II. Nerve regeneration and histomorphometric assessment. J Reconstr Microsurg 2006; 22(2): 123‒8.
12. Izquierdo O, Alvarez R, Aparicio P, Castellanos J, Dominguez E. Effect of platelet-rich plasma on peripheral nerve regeneration, model in rat. J Bone Joint Surg 2011; 93: 132‒3.
13. Küçük L, Günay H, Erbaş O, Küçük Ü, Atamaz F, Coşkunol E. Effects of platelet-rich plasma on nerve regeneration in a rat model. Acta Orthop Traumatol Turc 2014; 48(4): 449‒54.
14. Duka M, Lazić Z, Bubalo M. Effect of local administration of platelet-rich plasma and guided tissue regeneration on the level of bone resorption in early dental implant insertion Vojnosanit Pregl 2008; 65(6): 462–8. (Serbian)
15. Giorgetti M, Siciliano G. Platelet-rich plasma: the role in neural repair. Neural Regen Res 2015; 10(12): 1920–1.
16. Lichtenfels M, Colomé L, Sebben AD, Braga-Silva J. Effect of Platelet Rich Plasma and Platelet Rich Fibrin on sciatic nerve regeneration in a rat model. Microsurgery 2013; 33(5): 383‒90.
17. Abbasipour-Dalivand S, Mohammadi R, Mohammadi V. Effects of Local Administration of Platelet Rich Plasma on Functional Recovery after Bridging Sciatic Nerve Defect Using Silicone Rubber Chamber; An Experimental Study. Bull Emerg Trauma 2015; 3(1): 1‒7.
18. Zheng C, Zhu Q, Liu X, Huang X, He C, Jiang L, Q, et al. Improved peripheral nerve regeneration using acellular nerve allografts loaded with platelet-rich plasma. Tissue Eng Part A 2014; 20(23‒24): 3228‒40.
19. Fatemi MJ, Pakfetrat F, Akhoondinasab MRA, Mansouri K, Moosavi SJ, Hosseini SA, et al. The effect of sub-epineural platelet-rich plasma (PRP) on regeneration of the sciatic nerve in a rat model. Tehran Univ Med J 2016; 73(10): 693‒9.
20. Giannessi E, Coli A, Stornelli MR, Miragliotta V, Pirone A, Lenzi C, et al. An autologously generated platelet-rich plasma suturable membrane may enhance peripheral nerve regeneration after neurorraphy in an acute injury model of sciatic nerve neurotmesis. J Reconstr Microsurg 2014; 30(9): 617‒26.
21. Sabongi RG, De Rizzo LA, Fernandes M, Valente SG, Gomes dos Santos JB, Faloppa F, et al. Nerve regeneration: is there an alternative to nervous graft? J Reconstr Microsurg 2014; 30(9): 607‒16.
22. Sánchez M, Anitua E, Delgado D, Sanchez P, Prado R, Goiriena JJ, et al. A new strategy to tackle severe knee osteoarthritis: Combination of intra-articular and intraosseous injections of Platelet Rich Plasma. Expert Opin Biol Ther 2016; 16(5): 627‒43.
23. Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, et al. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc 2012; 20(10): 2082‒91.
24. Filardo G, Kon E, Roffi A, Di Matteo B, Merli ML, Marcacci M. Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc 2015; 23(9): 2459‒74.
25. de Almeida AM, Demange MK, Sobrado MF, Rodrigues MB, Pedrinelli A, Hernandez AJ. Patellar tendon healing with platelet-rich plasma: a prospective randomized controlled trial. Am J Sports Med 2012; 40(6): 1282‒8.
26. Taschieri S, Testori T, Corbella S, Weinstein R, Francetti L, Di Giancamillo A, et al. Platelet-Rich Plasma and Deproteinized Bovine Bone Matrix in Maxillary Sinus Lift Surgery: A Split-Mouth Histomorphometric Evaluation. Implant Dent 2015; 24(5): 592‒7.
27. Kumar KA, Rao JB, Pavan Kumar B, Mohan AP, Patil K, Parimala K. A prospective study involving the use of platelet rich plasma in enhancing the uptake of bone grafts in the oral and maxillofacial region. J Maxillofac Oral Surg 2013; 12(4): 387‒94.
28. Eskan MA, Greenwell H, Hill M, Morton D, Vidal R, Shumway B, et al. Platelet-rich plasma-assisted guided bone regeneration for ridge augmentation: a randomized, controlled clinical trial. J Periodontol 2014; 85(5): 661‒8.
29. Daif ET. Effect of autologous platelet-rich plasma on bone regeneration in mandibular fractures. Dent Traumatol 2013; 29(5): 399‒403.
30. Menezes DJ, Shibli JA, Gehrke SA, Beder AM, Sendyk WR. Effect of platelet-rich plasma in alveolar distraction osteogenesis: a controlled clinical trial. Br J Oral Maxillofac Surg 2016; 54(1): 83‒7.
31. Del Fabbro M, Corbella S, Taschieri S, Francetti L, Weinstein R. Autologous platelet concentrate for post-extraction socket healing: a systematic review. Eur J Oral Implantol 2014; 7(4): 333‒44.