Download PDF
J Reconstr Microsurg 2003; 19(5): 331-340
DOI: 10.1055/s-2003-42502
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Histologic Analysis of Schwann Cell Migration and Peripheral Nerve Regeneration in the Autogenous Venous Nerve Conduit (AVNC)

Charles Y. Tseng1,2,3 , GuoLi Hu3 , Richard T. Ambron3 , David T.W. Chiu1,2,3,4
  • 1Center for Restorative Surgery, College of Physicians and Surgeons, Columbia University, New York, NY
  • 2Department of Otolaryngology, College of Physicians and Surgeons, Columbia University, New York, NY
  • 3Department of Anatomy and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY
  • 4Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY
Further Information

Publication History

Publication Date:
24 September 2003 (online)

    Permissions and Reprints

ABSTRACT

Over the last two decades, the autogenous venous nerve conduit (AVNC) has been established as an effective treatment modality for the repair of nerve gaps less than 3 cm. In this study, the spatial-temporal progression of Schwann-cell migration and peripheral-nerve regeneration across a 10-mm gap bridged by a venous conduit was examined, using immunoctyochemical techniques. Histologic analysis revealed that the process of nerve regeneration through an AVNC occurs in four phases: the hematoma phase, cellular migration phase, axonal advancement phase, and myelination and maturation phase. The authors found that: 1) the lumen of the vein conduit remains patent throughout the process of nerve regeneration; 2) Schwann cells migrate into the vital space of the vessel lumen from the proximal and distal nerve stumps; 3) axonal growth into the conduit lags behind Schwann-cell migration; 4) Schwann cells migrate to the regenerating axons to form mature nodes of Ranvier when the distal stump is present; and 5) mechanical injury alone is sufficient to induce axonal outgrowth from the proximal nerve stump.

KEYWORDS

Vein conduit - nerve regeneration - Schwann cells

REFERENCES

  • 1 Chiu D TW, Janecka I, Krizek T J. et al . Autogenous vein graft as a conduit for nerve regeneration.  Surgery . 1982;  91 226-233
    PubMedGoogle Scholar
  • 2 Rice D H, Berstein F D. The use of autogenous vein for nerve grafting.  Otolaryngology, Head Neck Surg . 1984;  92 410
    PubMedGoogle Scholar
  • 3 Chiu D TW, Lovelace R E, Yu L. et al . Comparative electrophysiologic evaluation of nerve grafts and autogenous vein grafts as nerve conduits: an experimental study.  J Reconstr Microsurg . 1988;  4 303-310
    PubMedGoogle Scholar
  • 4 Suematsu N, Atsuta Y, Hirayama T. et al . Vein graft for repair of peripheral nerve gap.  J Reconstr Microsurg . 1988;  4 313-318
    PubMedGoogle Scholar
  • 5 Chiu D TW, Strauch B. A prospective clinical evaluation of autogenous vein grafts used as a nerve conduit for distal sensory nerve defects of 3 cm or less.  Plast Reconstr Surg . 1990;  86 928-934
    CrossrefPubMedGoogle Scholar
  • 6 Walton R L, Brown R E, Matory W E. et al . Autogenous vein graft repair of digital nerve defects in the finger: a retrospective clinical study.  Plast Reconstr Surg . 1989;  84 944-952
    CrossrefPubMedGoogle Scholar
  • 7 Tang J B, Gu Y Q, Song Y S. Repair of digital nerve defect, with autogenous vein graft during flexor tendon surgery in zone 2.  J Hand Surg . 1993;  18B 449-453
    PubMedGoogle Scholar
  • 8 Malizos K N, Dailiana Z H, Anastasiou E A. et al . Neuromas and gaps of sensory nerves of the hand: management using vein conduits.  Am J Orthop . 1997;  7 481-485
    PubMedGoogle Scholar
  • 9 Nahabedian M Y, Smolev J K. Successful reinnervation of the penis using an autogenous vein conduit.  J Reconstr Microsurg . 1998;  1 31-33
    PubMedGoogle Scholar
  • 10 Stahl S, Rosenberg N. Digital nerve repair by autogenous vein graft in high-velocity gunshot wounds.  Mil Med . 1999;  8 603-604
    PubMedGoogle Scholar
  • 11 Pogrel M A, Maghen A. The use of autogenous vein grafts for inferior alveolar and lingual nerve reconstruction.  J Oral Maxillofac Surg . 2001;  9 985-988
    PubMedGoogle Scholar
  • 12 Glasby M A, Gschmeissner S E, Hitchcock R JI, Huang C LH. The dependence of nerve regeneration through muscle grafts in the rat on the availability and orientation of basement membrane.  J Neurocytol . 1986;  15 497
    CrossrefPubMedGoogle Scholar
  • 13 Jiming K, Shizhen Z, Bo S, Shengxiu Z. Experimental study of bridging the peripheral nerve gap with skeletal muscle.  Microsurgery . 1986;  7 183
    CrossrefPubMedGoogle Scholar
  • 14 Wang K K, Costas P D, Bryan D J. et al . Inside-out vein graft promotes improved nerve regeneration in rats.  Microsurgery . 1993;  14 608-618
    PubMedGoogle Scholar
  • 15 Gibby W A, Koerber H R, Horch K W. A quantitative evaluation of suture and tubulization nerve repair techniques.  J Neurosurg . 1983;  58 574
    PubMedGoogle Scholar
  • 16 Brunelli G A. Bridging nerve defects with combined skeletal muscle and vein conduits.  Microsurgery . 1993;  14 247-251
    CrossrefPubMedGoogle Scholar
  • 17 Battiston B, Tos P, Cushway T R, Geuna S. Nerve repair by means of vein filled with muscle grafts I. Clinical results.  Microsurgery . 2000;  1 32-6
    PubMedGoogle Scholar
  • 18 Tang J B. Vein conduits with interposition of nerve tissue for peripheral nerve defects.  J Reconstr Microsurg . 1995;  11 21-26
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Molander H, Olsson Y, Engkvist O. Regeneration of a peripheral nerve through a polyglactin tube.  Muscle Nerve . 1982;  5 54
    CrossrefPubMedGoogle Scholar
  • 20 Dellon A L, Mackinnon S E. An alternative to the classical nerve graft for the management of the short nerve gap.  Plast Reconstr Surg . 1988;  82 849
    CrossrefPubMedGoogle Scholar
  • 21 Lundborg G, Gelberman R H, Longo F M. et al . In vivo regeneration of cut nerves encased in silicone tubes: growth across a six-millimeter gap.  J Neuropathol Exp Neurol . 1982;  41 412
    CrossrefPubMedGoogle Scholar
  • 22 Thoenen H, Bandtlow C, Heumann R. et al . Nerve growth factor: cellular localization and regulation of synthesis.  Cell Mol Neurobiol . 1988;  8 35
    CrossrefPubMedGoogle Scholar
  • 23 Lundborg G, Dahlin L, Danielsen N, Zhao Q. Trophism, tropism, and specificity in nerve regeneration.  J Reconstr Microsurg . 1994;  10 5
    PubMedGoogle Scholar
  • 24 Bancroft J, Gamble M. Theory and Practice of Histological Techniques, 5th ed.  Edinburgh: Churchill Livingston 2002
    Google Scholar
      >