中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (9): 1639-1649.doi: 10.4103/1673-5374.276325

• 综述:颅神经损伤修复保护与再生 • 上一篇    下一篇

运动性颅神经损伤的动子素再生和重建现状

  

  • 出版日期:2020-09-08 发布日期:2020-09-23

Current landscape in motoneuron regeneration and reconstruction for motor cranial nerve injuries

Yanjun Xie1 , Kevin J. Schneider1 , Syed A. Ali1 , Norman D. Hogikyan1 , Eva L. Feldman2 , Michael J. Brenner1, *   

  1.  1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA 2 Department of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA
  • Online:2020-09-08 Published:2020-09-23
  • Contact: Michael J. Brenner, MD, FACS, mbren@med.umich.edu.
  • Supported by:
    This work was supported by the United States National Institute of Health grant 1K08DC012535 (to MJB), Program for Neurology Research and Discovery, and the Sinai Medical Staff Foundation Neuroscience Scholar Fund (to ELF).

摘要: orcid:  0000-0003-4926-0957 (Michael J. Brenner)

Abstract: The intricate anatomy and physiology of cranial nerves have inspired clinicians and scientists to study their roles in the nervous system. Damage to motor cranial nerves may result from a variety of organic or iatrogenic insults and causes devastating functional impairment and disfigurement. Surgical innovations directed towards restoring function to injured motor cranial nerves and their associated organs have evolved to include nerve repair, grafting, substitution, and muscle transposition. In parallel with this progress, research on tissue-engineered constructs, development of bioelectrical interfaces, and modulation of the regenerative milieu through cellular, immunomodulatory, or neurotrophic mechanisms has proliferated to enhance the available repertoire of clinically applicable reconstructive options. Despite these advances, patients continue to suffer from functional limitations relating to inadequate cranial nerve regeneration, aberrant reinnervation, or incomplete recovery of neuromuscular function. These shortfalls have profound quality of life ramifications and provide an impetus to further elucidate mechanisms underlying cranial nerve denervation and to improve repair. In this review, we summarize the literature on reconstruction and regeneration of motor cranial nerves following various injury patterns. We focus on seven cranial nerves with predominantly efferent functions and highlight shared patterns of injuries and clinical manifestations. We also present an overview of the existing reconstructive approaches, from facial reanimation, laryngeal reinnervation, to variations of interposition nerve grafts for reconstruction. We discuss ongoing endeavors to promote nerve regeneration and to suppress aberrant reinnervation and the development of synkinesis. Insights from these studies will shed light on recent progress and new horizons in understanding the biomechanics of peripheral nerve neurobiology, with emphasis on promising strategies for optimizing neural regeneration and identifying future directions in the field of motor cranial neuron research.

Key words: axon degeneration, cranial neuropathy, facial nerve, facial paralysis, motoneuron, nerve regeneration, peripheral nerve, recurrent laryngeal nerve, synkinesis, vocal fold paralysis