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

Neural Regeneration Research 2020年第9期15卷 1639-1649页

作者： Yanjun Xie Kevin J.Schneider Syed A.Ali Norman D.Hogikyan Eva L.Feldman Michael J.Brenner Department of Otolaryngology-Head and Neck Surgery University of Michigan Medical SchoolAnn ArborMIUSA Department of Neurology University of Michigan Medical SchoolAnn ArborMIUSA

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

关键词： axon degeneration cranial neuropathy facial nerve facial paralysis motoneuron nerve regeneration peripheral nerve recurrent laryngeal nerve synkinesis vocal fold paralysis

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Conductive hearing loss in chronic inflammatory demyelinating polyneuropathy(CIDP):A case report

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Journal of Otology 2018年第4期13卷 141-144页

作者： Mark A.Fadel Kevin Y.Zhan Edward E.Dodson University of Toledo College of Medicine&Life Sciences 3000 Arlington AveToledoOH43614USA The Ohio State University Wexner Medical Center Department of Otolaryngology-Head&Neck Surgery915 Olentangy River RdColumbusOH43212USA

Chronic inflammatory demyelinating polyneuropathy(CIDP) is a progressive autoimmune disorder that targets peripheral nerves. It commonly presents with motor-predominant dysfunction and enlargement of cranial nerves. With regards to hearing loss, a few cases of sensorineural loss have been described. We present a novel case of conductive hearing loss caused by a mass on the tympanic segment of the facial nerve in the setting of CIDP.

关键词： Chronic inflammatory demyelinating polyneuropathy Hearing loss Ossicular erosion cranial neuropathy

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