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Andrzej Marchel - One of the best experts on this subject based on the ideXlab platform.
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HemiHypoglossal−Facial Nerve Anastomosis for Facial Nerve Reanimation: Case Series and Technical Note
World neurosurgery, 2018Co-Authors: Tomasz Dziedzic, Przemysław Kunert, Andrzej MarchelAbstract:Hypoglossal Nerve Injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the Hypoglossal-facial Nerve anastomosis bilaterally, a technique that includes partial splitting of the Hypoglossal Nerve and skeletonization of the facial Nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and Hypoglossal Nerves after the procedure. Prospectively collected data from 56 consecutive patients who underwent hemiHypoglossal-facial Nerve anastomosis (HHFA) were analyzed. The outcome was correlated with epidemiologic data, initial disease, the presence of neurofibromatosis type 2, previous radiosurgery, and the time between Nerve Injury and reconstructive surgery. Forty-eight (84%) patients achieved satisfactory outcomes; 8 of them (14%) showed some improvement, and in 1 patient (2%) there was no improvement during long-term observation. The result at follow-up was not related to the time interval between the 2 procedures. However, recovery times for facial tonicity were statistically significantly longer if the procedure was performed after 12 months (P = 0.044). There was no statistically significant association between patient age (P = 0.96) or sex (P = 0.13) and facial Nerve function. HHFA resulted in no or minimal tongue atrophy without deviation in 53 patients (93%), and the remainder had mild hemiatrophy with tongue deviation <30 degrees. HHFA is an effective technique for facial Nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods. Copyright © 2018 Elsevier Inc. All rights reserved.
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HemiHypoglossal−Facial Nerve Anastomosis for Facial Nerve Reanimation: Case Series and Technical Note
World neurosurgery, 2018Co-Authors: Tomasz Dziedzic, Przemysław Kunert, Andrzej MarchelAbstract:Background Hypoglossal Nerve Injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the Hypoglossal-facial Nerve anastomosis bilaterally, a technique that includes partial splitting of the Hypoglossal Nerve and skeletonization of the facial Nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and Hypoglossal Nerves after the procedure. Methods Prospectively collected data from 56 consecutive patients who underwent hemiHypoglossal−facial Nerve anastomosis (HHFA) were analyzed. The outcome was correlated with epidemiologic data, initial disease, the presence of neurofibromatosis type 2, previous radiosurgery, and the time between Nerve Injury and reconstructive surgery. Results Forty-eight (84%) patients achieved satisfactory outcomes; 8 of them (14%) showed some improvement, and in 1 patient (2%) there was no improvement during long-term observation. The result at follow-up was not related to the time interval between the 2 procedures. However, recovery times for facial tonicity were statistically significantly longer if the procedure was performed after 12 months (P = 0.044). There was no statistically significant association between patient age (P = 0.96) or sex (P = 0.13) and facial Nerve function. HHFA resulted in no or minimal tongue atrophy without deviation in 53 patients (93%), and the remainder had mild hemiatrophy with tongue deviation Conclusions HHFA is an effective technique for facial Nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods.
Hiroshi Kiyama - One of the best experts on this subject based on the ideXlab platform.
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A DAP12-dependent signal promotes pro-inflammatory polarization in microglia following Nerve Injury and exacerbates degeneration of injured neurons.
Glia, 2015Co-Authors: Masaaki Kobayashi, Hiroyuki Konishi, Toshiyuki Takai, Hiroshi KiyamaAbstract:Under pathological conditions, activated microglia play paradoxical roles and could have neurotoxic or neuroprotective effects. However, the signal determining how activated microglia affects the fate of neuronal cells remains largely unknown. Here we demonstrate that DNAX-activating protein of 12 kDa (DAP12), a transmembrane adaptor protein that contains an immunoreceptor tyrosine-based activation motif, is a critical regulator of microglial function after Nerve Injury. In a model of mouse Hypoglossal Nerve Injury, the duration of microglial increase after Nerve Injury became shorter in mice lacking DAP12, although microglial morphology and total cell numbers were not significantly affected during early phase after Nerve Injury. Intriguingly, expressions of M1-phenotype markers including pro-inflammatory cytokines were suppressed in DAP12-deficient microglia. Furthermore, axotomy-induced motor neuron death was markedly prevented in DAP12-deficient mice. Collectively, DAP12-mediated microglial activation following axotomy promotes pro-inflammatory responses, and thereby accelerates Nerve Injury-induced neuron death, suggesting that DAP12 is a potential therapeutic target for the protection of neuronal degeneration caused by microglial activation.
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microrna 124 is down regulated in Nerve injured motor neurons and it potentially targets mrnas for klf6 and stat3
Neuroscience, 2014Co-Authors: Kenichi Nagata, Hiroshi Kiyama, Isuzu Hama, Sumiko KiryuseoAbstract:MicroRNA (miRNA) is a small non-coding RNA that regulates gene expression by degrading target mRNAs or inhibiting translation. Although many miRNAs play important roles in various conditions, it is unclear whether miRNAs are involved in motor Nerve regeneration. In this study, we identified the possible implication of miR-124 in Nerve regeneration using a mouse Hypoglossal Nerve Injury model. The significant down-regulation of miR-124 was observed in injured Hypoglossal motor neurons after Nerve Injury, and this transient down-regulation showed a clear inverse correlation with the up-regulation of KLF6 and STAT3, known as axon elongation factor and regeneration-associated molecules, respectively. Furthermore, the luciferase assay and in vitro gain of function methods supported that both genes could be potent targets of miR-124. These results suggest that Injury-induced repression of miR-124 may be implicated in the regulation of expression of several Injury-associated transcription factors, which are crucial for appropriate Nerve regeneration.
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Suture of transected Nerve suppresses expression of BH3-only protein Noxa in Nerve-transected motor neurons of C57BL/6J mouse.
Journal of neurotrauma, 2007Co-Authors: Kazushige Gamo, Sumiko Kiryu-seo, Hideki Yoshikawa, Hiroshi KiyamaAbstract:Disrupted peripheral Nerves are typically sutured as spontaneous recovery does not always occur. However, the molecular mechanisms involved in Nerve regeneration following end-to-end Nerve suture are obscure. Here, we investigated effects of end-to-end Nerve suture after peripheral Nerve transection on motor neurons, using the C57BL/6J mouse Hypoglossal Nerve Injury model. In this animal model, 60-80% of injured motor neurons gradually progress to neuronal death, while the remaining injured neurons survive and regenerate. Mice were divided into the Cut and Suture groups. In the Cut group, the right Hypoglossal Nerve was transected. In the Suture group, the right Hypoglossal Nerve was transected and then was repaired using end-to-end Nerve suture. We assessed differences between the Cut and Suture groups by analyzing the neuronal survival rate by thionine staining and the Nerve terminal regeneration rate by vesicular acetylcholine transporter (VAChT) immunohistochemistry, which is a marker for cholinergic presynaptic terminal. We found that 82.9% of motor neurons survived in the Suture group, whereas only 39.2% of motor neurons did in the Cut group 56 days after surgery. At that time point, 86% of presynaptic terminals compared to controls were regenerated in the Suture group, and 21% were regenerated in the Cut group. These results demonstrate that peripheral Nerve suture prevented death of Nerve-transected motor neurons and promoted Nerve regeneration. We also examined expression profiles of major survival and death signal-associated genes in Hypoglossal nuclei using in situ hybridization and real-time polymerase chain reaction (PCR). Although most of the survival- and death-associated genes were regulated in a similar manner in both groups, expression of BH3-only protein Noxa mRNA was significantly lower in the Suture than in the Cut group. A significant suppression of Noxa expression by the Suture may be a major reason why Nerve suture induces survival and regeneration of Nerve-injured motor neurons.
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Altered expression of Smad family members in injured motor neurons of rat.
Brain research, 2006Co-Authors: Noriko Okuyama, Sumiko Kiryu-seo, Hiroshi KiyamaAbstract:Abstract We examined changes in the expression of Smad family members, which transduce signals from TGF-β superfamily ligands, following Hypoglossal Nerve Injury. RT–PCR and in situ hybridization revealed that Smad1, 2, 3 and 4 mRNAs were significantly up-regulated in injured side, whereas Smad8 mRNA was down-regulated. Immunohistochemistry and Western blotting analysis confirmed the alterations of Smad1, 2 and 4 in injured neurons. These results suggest that the Smad signaling may be important for Nerve regeneration.
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Annexin III implicated in the microglial response to motor Nerve Injury.
Glia, 2006Co-Authors: Hiroyuki Konishi, Kazuhiko Namikawa, Hiroshi KiyamaAbstract:To identify proteins implicated in peripheral Nerve regeneration, we performed two-dimensional polyacrylamide gel electrophoresis and subsequent mass spectrometry analysis using Nerve-injured Hypoglossal nuclei of rat. We have identified annexin III (ANX III/ANX A3) as an induced protein after rat Hypoglossal Nerve Injury. ANX III is known as a Ca2+-dependent phospholipid-binding protein, but its physiological function is mostly unknown. By in situ hybridization and immunohistochemistry, we demonstrated that ANX III expression was induced specifically in activated (axotomy-stimulated) microglia after Nerve Injury. ANX III was the most prominent ANX expressed in microglia of the major ANX family members (ANX I-VI). Hybridization signals for other ANX mRNAs (II, IV, V, and VI) were mainly observed in neuronal cells, and no significant hybridization signal for ANX I mRNA was detected in Hypoglossal nuclei. In cultured microglia, ATP treatment induced ANX III translocation to the ruffling membrane where F-actin was accumulated. Further in vitro studies revealed that ANX III was not secreted and had F-actin binding activity in a Ca2+-dependent manner. These results suggest that ANX III may be a Ca2+-dependent mediator between phospholipids and F-actin in microglia stimulated by peripheral Nerve Injury. © 2006 Wiley-Liss, Inc.
Tomasz Dziedzic - One of the best experts on this subject based on the ideXlab platform.
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HemiHypoglossal−Facial Nerve Anastomosis for Facial Nerve Reanimation: Case Series and Technical Note
World neurosurgery, 2018Co-Authors: Tomasz Dziedzic, Przemysław Kunert, Andrzej MarchelAbstract:Hypoglossal Nerve Injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the Hypoglossal-facial Nerve anastomosis bilaterally, a technique that includes partial splitting of the Hypoglossal Nerve and skeletonization of the facial Nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and Hypoglossal Nerves after the procedure. Prospectively collected data from 56 consecutive patients who underwent hemiHypoglossal-facial Nerve anastomosis (HHFA) were analyzed. The outcome was correlated with epidemiologic data, initial disease, the presence of neurofibromatosis type 2, previous radiosurgery, and the time between Nerve Injury and reconstructive surgery. Forty-eight (84%) patients achieved satisfactory outcomes; 8 of them (14%) showed some improvement, and in 1 patient (2%) there was no improvement during long-term observation. The result at follow-up was not related to the time interval between the 2 procedures. However, recovery times for facial tonicity were statistically significantly longer if the procedure was performed after 12 months (P = 0.044). There was no statistically significant association between patient age (P = 0.96) or sex (P = 0.13) and facial Nerve function. HHFA resulted in no or minimal tongue atrophy without deviation in 53 patients (93%), and the remainder had mild hemiatrophy with tongue deviation <30 degrees. HHFA is an effective technique for facial Nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods. Copyright © 2018 Elsevier Inc. All rights reserved.
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HemiHypoglossal−Facial Nerve Anastomosis for Facial Nerve Reanimation: Case Series and Technical Note
World neurosurgery, 2018Co-Authors: Tomasz Dziedzic, Przemysław Kunert, Andrzej MarchelAbstract:Background Hypoglossal Nerve Injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the Hypoglossal-facial Nerve anastomosis bilaterally, a technique that includes partial splitting of the Hypoglossal Nerve and skeletonization of the facial Nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and Hypoglossal Nerves after the procedure. Methods Prospectively collected data from 56 consecutive patients who underwent hemiHypoglossal−facial Nerve anastomosis (HHFA) were analyzed. The outcome was correlated with epidemiologic data, initial disease, the presence of neurofibromatosis type 2, previous radiosurgery, and the time between Nerve Injury and reconstructive surgery. Results Forty-eight (84%) patients achieved satisfactory outcomes; 8 of them (14%) showed some improvement, and in 1 patient (2%) there was no improvement during long-term observation. The result at follow-up was not related to the time interval between the 2 procedures. However, recovery times for facial tonicity were statistically significantly longer if the procedure was performed after 12 months (P = 0.044). There was no statistically significant association between patient age (P = 0.96) or sex (P = 0.13) and facial Nerve function. HHFA resulted in no or minimal tongue atrophy without deviation in 53 patients (93%), and the remainder had mild hemiatrophy with tongue deviation Conclusions HHFA is an effective technique for facial Nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods.
Regis W. Haid - One of the best experts on this subject based on the ideXlab platform.
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C1-C2 transarticular screw fixation: technical aspects.
Neurosurgery, 2001Co-Authors: Regis W. HaidAbstract:OBJECTIVE: I review posterior atlantoaxial fusion with transarticular screw fixation, including indications, complications, and operative technique, emphasizing my experience. METHODS: The indications for C1-C2 transarticular screw fixation include traumatic injuries to the atlantoaxial complex, instability resulting from inflammatory disease (rheumatoid arthritis), and congenital abnormalities (os odontoideum). All patients underwent stabilization using cannulated C1-C2 transfacetal screws by the method described by Magerl. Supplemental interspinous fusion with bicortical autologous iliac crest graft and titanium cable was used to restore the posterior tension band by use of the method described by Sonntag's group. Preoperatively, all patients underwent imaging with plain radiographs, magnetic resonance imaging, and axial computed tomography. Patients were maintained in a rigid cervical orthosis postoperatively. RESULTS: Measures used to improve safety and efficacy include patient positioning, fluoroscopic guidance, preoperative magnetic resonance imaging, axial computed tomography, and open reduction of C1-C2 subluxation before screw passage. In this series of 75 patients, fusion was obtained in 72 patients (96%). There were no instances of vertebral artery Injury, errant screw placement, instrumentation failure, dural laceration, spinal cord Injury, or Hypoglossal Nerve Injury. CONCLUSION: C1-C2 transarticular screw fixation with a posterior tension band construct provides excellent fusion rates with few perioperative complications. Preoperative imaging and meticulous surgical technique improve outcomes.
Nabil Hokayem - One of the best experts on this subject based on the ideXlab platform.
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treating facial Nerve palsy by true termino lateral Hypoglossal facial Nerve anastomosis
Journal of Plastic Reconstructive and Aesthetic Surgery, 2010Co-Authors: Fadi H. Sleilati, Marwan Nasr, Henri A. Stephan, Z.d. Asmar, Nabil HokayemAbstract:Hypoglossal-facial Nerve anastomosis is a time-proven technique for the repair of facial Nerve palsy. Efforts have been made to reduce Hypoglossal Nerve Injury, the main drawback of the technique. In this study, the anastomosis is a true termino-lateral neurorrhaphy with only an epineural window in the Hypoglossal Nerve sheath. A re-routing technique of the temporal facial Nerve is also performed to allow a direct anastomosis to the Hypoglossal Nerve without the need for a jump graft. The first three results reported are very encouraging, with a satisfactory return of facial mimics and without any impairment of lingual function.
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Treating facial Nerve palsy by true termino-lateral Hypoglossal–facial Nerve anastomosis
Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2010Co-Authors: Fadi H. Sleilati, Marwan Nasr, Henri A. Stephan, Z.d. Asmar, Nabil HokayemAbstract:Hypoglossal-facial Nerve anastomosis is a time-proven technique for the repair of facial Nerve palsy. Efforts have been made to reduce Hypoglossal Nerve Injury, the main drawback of the technique. In this study, the anastomosis is a true termino-lateral neurorrhaphy with only an epineural window in the Hypoglossal Nerve sheath. A re-routing technique of the temporal facial Nerve is also performed to allow a direct anastomosis to the Hypoglossal Nerve without the need for a jump graft. The first three results reported are very encouraging, with a satisfactory return of facial mimics and without any impairment of lingual function.