Terminolateral Neurorrhaphy: A Review of the Literature

ABSTRACT

Terminolateral neurorrhaphy (TLN) is an experimental technique for repairing peripheral nerves, when the proximal cut nerve stump is not available for traditional end-to-end repair. Over the past 7 years, the efficacy of TLN, its ability to preserve donor nerve function, the necessity of disrupting donor nerve connective tissue layers during the procedure, the mechanism by which TLN affords reinnervation, and the definition of the procedure, have been debated. In this critical review of TLN literature, the authors attempt to demonstrate 1) that a TLN in which the surgeon deliberately transects donor nerve axons is an effective method for peripheral nerve repair; the mechanisms by which axons innervate target muscles following this procedure are well-defined, and there is adequate experimental and clinical evidence to support its clinical application; and 2) that a TLN procedure in which the surgeon attempts to leave the donor nerve intact is neither mechanistically distinct from a TLN with deliberate donor nerve axotomy, nor is it as efficacious. Future studies should assess the degree of donor nerve transection that will maximize reinnervation via the TLN graft, without incurring functionally significant donor nerve deficits.

KEYWORD

End-to-side - terminolateral - nerve coaptation

REFERENCES

• 1 Rowan P R, Chen L, Urbaniak J R. End-to-side nerve repair: a review.  Hand Clin . 2000;  16 151-159
• 2 Al-Quattan M M. Terminolateral neurorrhaphy: review of experimental and clinical studies.  J Reconstr Microsurg . 2001;  17 99-108
• 3 Kennedy R. On the restoration of coordinated movement after nerve crossing with interchange of function of the cerebral cortical centers.  Phil Trans R Soc Lond . 1901;  194B 127
• 4 May M, Sobol S M, Mester S J. Hypoglossal-facial nerve interpositional-jump graft for facial reanimation without tongue atrophy.  Otolaryngol Head Neck Surg . 1991;  104 818-825
• 5 Nath R K, Mackinnon S E. Nerve transfers in the upper extremity.  Hand Clin . 2000;  16 131-139
• 6 Ranson S W. Degeneration and regeneration of nerve fibers.  J Comp Neurol . 1912;  22 487-546
• 7 Morris J H, Hudson A R, Weddell G A. A study of degeneration and regeneration in the divided rat sciatic nerve based on electron microscopy. II. The development of the ``regenerating unit''.  Z Zellforshung Mikrosk Anat . 1972;  124 103-130
• 8 Fu S Y, Gordon T. The cellular and molecular basis of peripheral nerve regeneration.  Mol Neurobiol . 1997;  14 67-116
• 9 Gordon T, Stein R B. Reorganization of motor-unit properties in reinnervated muscles of the cat.  J Neurophysiol . 1982;  48 1175
• 10 Cote C, Faulkner J A. Motor unit function in skeletal muscle autografts of rats.  Exp Neurol . 1984;  84 292
• 11 Foehring R C, Syper G W, Munson J B. Properties of self-reinnervated motor units of medial gastrocnemius of cat: I. Long-term reinnervation.  J Neurophysiol . 1986;  55 931
• 12 Van der Meulen H J, Cederna P S, Urbanchek M G. Contractile properties of motor units in reinnervated rate EDL muscle.  J Reconstr Microsurg . 1998;  14 594
• 13 Mackinnon S E, Dellon A L. Fascicular patterns of the hypoglossal nerve.  J Reconstr Microsurg . 1995;  11 195-198
• 14 Cusimano M D, Sekhar L. Partial hypoglossal to facial nerve anastomosis for reinnervation of the paralyzed face in patients with lower cranial nerve palsies: technical note.  Neurosurgery . 1994;  35 532-534
• 15 Arai H, Sato K, Yanai A. A hemihypoglossal-facial nerve anastomosis in treating unilateral facial palsy after acoustic neuroma resection.  J Neurosurg . 1995;  82 51-54
• 16 Sawamura Y, Abe H. Hypoglossal-facial nerve side-to-end anastomosis for preservaion of hypoglossal function: results of delayed treatment with a new technique.  J Neurosurg . 1997;  86 203-206
• 17 Asaoka K, Sawamura Y, Nagashima M, Fukushima T. Surgical anatomy for direct hypoglossal-facial side-to-end ``anastomosis''.  J Neurosurg . 1999;  91 268-275
• 18 Ballance C A, Ballance H A, Stewart P. Remarks on the operative treatment of chronic facial palsy of peripheral origin.  Br Med J . 1903;  2 1009-1013
• 19 Viterbo F, Trindade J C, Hoshino K, Mazzoni A. Latero-terminal neurorrhaphy without removal of the epineurial sheath: experimental study in rats.  Rev Paul Med . 1992;  110 267-275
• 20 Viterbo F, Trindade J C, Hoshino K, Mazzoni A. End-to-side neurorrhaphy with removal of the epineurial sheath: an experimental study in rats.  Plast Reconstr Surg . 1994;  94 1038-1047
• 21 Viterbo F, Trindade J C, Hoshino K, Mazzoni A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineurial sheath: experimental study in rats.  Br J Plast Surg . 1994;  47 75-80
• 22 Rovak J M, Cederna P S, Macionis. Termino-lateral neurorrhaphy: the functional axonal anatomy.  Microsurgery . 2000;  20 6-14
• 23 Sato T, Konishi F, Kanazawa K. End-to-side pudendal nerve anastomosis for the creation of a new reinforcing anal sphincter in dogs.  Surgery . 2000;  127 92-98
• 24 Lundborg G, Zhao Q, Kanje M. Can sensory and motor collateral sprouting be induced from intact peripheral nerve by end-to-side anastomosis?.  J Hand Surg . 1994;  19B 277-282
• 25 Noah E M, Williams A, Fortes W, Terzis J K. A new animal model to investigate axonal sprouting after end-to-side neurorrhaphy.  J Reconstr Microsurg . 1997;  13 317-325
• 26 Noah E M, Williams A, Jorgenson C. End-to-side neurorrhaphy: a histologic and morphometric study of axonal sprouting into an end-to-side nerve graft.  J Reconstr Microsurg . 1997;  13 99-106
• 27 Tarasidis G, Watanabe O, Mackinnon S E. End-to-side neurorraphy: a long-term study of neural regeneration in a rat model.  Otolaryngol Head Neck Surg . 1998;  119 337-341
• 28 Tarasidis G, Watanabe O, Mackinnon S E. End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model.  Ann Otol Rhinol Laryngol . 1997;  106 506-512
• 29 Zhao J Z, Chen Z W, Chen T Y. Nerve regeneration after terminolateral neurorrhaphy: experimental study in rats.  J Reconstr Microsurg . 1997;  13 31-37
• 30 Al-Qattan M M, al-Thunyan A. Variables affecting axonal regeneration following end-to-side neurorrhaphy.  Br J Plast Surg . 1998;  51 238-242
• 31 Chen Y G, Brushart T M. The effect of denervated muscle and Schwann cells on axon collateral sprouting.  J Hand Surg . 1998;  23A 1025-1033
• 32 Caplan J, Tiangco D A, Terzis J K. Effects of IGF-II in a new end-to-side model.  J Reconstr Microsurg . 1999;  15 351-358
• 33 Liu K, Chen L E, Seaber A V. Motor functional and morphological findings following end-to-side neurorrhaphy in the rat model.  J Orthop Res . 1999;  17 293-330
• 34 McCallister W V, Tang P, Trumble T E. Is end-to-side neurorrhaphy effective?.  <~>A study of axonal sprouting stimulated from intact nerves. J Reconstr Microsurg . 1999;  15 597-604
• 35 Giovanoli P, Koller R, Meuli-Simmen C. Functional and morphometric evaluation of end-to-side neurorrhaphy for muscle reinnervation.  Plast Reconstr Surg . 2000;  106 383-392
• 36 Lutz B S, Chuang D CC, Hsu J C. Selection of donor nerves-an important factor in end-to-side neurorrhaphy.  Br J Plast Surg . 2000;  53 149-154
• 37 Matsumoto M, Hirata H, Nishiyama M. Schwann cells can induce collateral sprouting from intact axons: experimental study of end-to-side neurorrhaphy using a Y-chamber model.  J Reconstr Microsurg . 1999;  15 281-286
• 38 Tham S K, Morrison W A. Motor collateral sprouting through an end-to-side nerve repair.  J Hand Surg . 1998;  23A 844-851
• 39 Kalliainen L K, Cederna P S, Kuzon W M. Mechanical function of muscle reinnervated by end-to-side neurorrhaphy.  Plast Reconstr Surg . 1999;  103 1919-1927
• 40 Cao X, Tamai M, Kizaki K. Choline acetyltransferase activity in collateral sprouting of peripheral nerve after surgical intervention: experimental study in rats.  J Reconstr Microsurg . 1999;  15 443-448
• 41 Zhang Z, Soucacos P N, Bo J, Beris A E. Evaluation of collateral sprouting after end-to-side nerve coaptation using a fluorescent double-labeling technique.  Microsurgery . 1999;  19 281-286
• 42 Weddell G, Guttmann L, Gutmann E. The local extension of nerve fibres into denervated areas of skin.  J Neurol Psych . 1941;  4 206-225
• 43 Devor M, Schonfeld D, Seltzer Z, Wall P D. Two modes of cutaneous reinnervation following peripheral nerve injury.  J Comp Neurol . 1979;  185 211-220
• 44 Kovacic U, Bajrovic F, Sketelj J. Recovery of cutaneous pain sensitivity after end-to-side nerve repair in the rat.  J Neurosurg . 1999;  91 857-862
• 45 Cederna P S, Kalliainen L K, Urbanchek M G. ``Donor'' muscle structure and function following end-to-side neurorrhaphy.  Plast Reconstr Surg . 2001;  107 789-796
• 46 Zhang Z, Soucacos P N, Beris A E. Long-term evaluation of rat peripheral nerve repair with end-to-side neurorrhaphy.  J Reconstr Microsurg . 2000;  16 303-313
• 47 Kostakoglu N. Motor and sensory reinnervation in the hand after an end-to-side median to ulnar nerve coaptation in the forearm.  Br J Plast Surg . 1999;  52 404-407
• 48 Viterbo F. Nerve graftings and end-to-side neurorrhaphies connecting the phrenic nerve to the brachial plexus.  Plast Reconstr Surg . 1995;  96 494-495
• 49 Mennen U. End-to-side nerve suture-a technique to repair peripheral nerve injury.  S Afr Med J . 1999;  89 1188-1194
• 50 Mennen U. End-to-side nerve suture in the human patient.  Hand Surg . 1998;  3 7-15
• 51 Mackinnon S E, Dellon A L, O'Brien J. Changes in nerve fibre numbers distal to nerve repair in the rat sciatic nerve model.  Muscle Nerve . 1991;  14 1116-1122
• 52 Brushart T M. Motor axons preferentially reinnervate motor pathways.  J Neurosci . 1993;  13 2730-2738
• 53 Stoll G, Muller H W. Axonal degeneration and neural regeneration: basic insights.  Brain Pathol . 1999;  9 313-325
• 54 Bertelli J A, Santos A RS, Calixto J B. Is axonal sprouting able to traverse the conjunctival layers of the peripheral nerve?.  <~>A behavioral, motor, and sensory study of end-to-side nerve anastomosis. J Reconstr Microsurg . 1996;  12 559-563
• 55 Fortes W M, Noah E M, Liuzzi F J, Terzis J K. End-to-side neurorrhaphy: evaluation of axonal response and upregulation of IGF-I and IFG-II in a non-injury model.  J Reconstr Microsurg . 1999;  15 449-457
• 56 Tiangco D A, Papakonstantinou K C, Mullinax K A, Terzis J K. IGF-I and end-to-side nerve repair: a dose-response study.  J Reconstr Microsurg . 2001;  17 247-256
• 57 Lutz B S, Ma S F, Chuang D CC, Wei F C. Role of the target in end-to-side neurorrhaphy: reinnervation of a single muscle versus multiple muscles.  J Reconstr Microsurg . 2000;  16 443-448
• 58 Gallo G, Letourneau P C. Localized sources of neurotrophins initiate axon collateral sprouting.  J Neurosci . 1998;  18 5403-5414
• 59 Guntinas-Lichius O, Effenberger K, Angelov D N. Delayed rat facial nerve repair leads ot accelerated and enhanced muscle reinnervation with reduced collateral axonal sprouting during a definite denervation period using a cross-anastomosis paradigm.  Exp Neurol . 2000;  162 98-111
• 60 Harsh C, Archibald S J, Madison R D. Double-labeling of saphenous nerve neuron pools: a model for determining the accuracy of axon regeneration at the single neuron level.  J Neurosci Methods . 1991;  39 123-129