TY - JOUR
T1 - Vastus lateralis vascularized nerve graft in facial nerve reconstruction
T2 - An anatomical cadaveric study and clinical implications
AU - Agrogiannis, Nikolaos
AU - Rozen, Shai
AU - Reddy, Gangadasu
AU - Audolfsson, Thorir
AU - Rodriguez-Lorenzo, Andres
N1 - Publisher Copyright:
© 2014 Wiley Periodicals, Inc.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: The present study investigates the vascular anatomy of the vastus lateralis motor nerve (VLMN) to be used as a vascularized nerve graft in facial nerve reconstruction. We evaluated the maximum length of the nerve that can be included in the flap and its vascular pedicle. In addition, we discuss its adequacy for use in early reconstruction of the facial nerve both as ipsilateral facial nerve reconstruction and as cross-facial nerve graft. Methods: Five fresh cadavers were used in this study. In all specimens, the VLMN and its vascular pedicle were dissected, photodocumented and measured using calipers. In addition, two vascularized VLMN were injected with a radiopaque contrast and underwent CT angiography and three dimensional reconstructions were scanned to illustrate the vascular supply of the nerve using OsiriX Software. Results: The VLMN was divided into two divisions, an oblique proximal and a descending distal, in 70% of the dissections with a mean maximal length of 8.4±4.5 cm for the oblique division and 15.03±3.87 cm for the descending division. The length of the oblique division, when present, was shorter than the length of the descending branch in all specimens. The mean length of the pedicle was 2.93±1.69 cm, and 3.27±1.49 cm until crossing the oblique and the descending division of the nerve respectively. The mean caliber of the nerve was 2.4±0.62 mm. Three-dimensional computed tomography angiography demonstrated perfusion throughout the entire VLMN by branches from the descending branch of the lateral femoral circumflex artery which ran parallel to the descending division of the VLMN. Additionally, we observed that technically it was possible to preserve the oblique branch of the VLMN. Conclusion: This study confirms that VLMN presents adequate anatomic features to be used as a vascularized nerve graft for facial nerve reconstruction in terms of length, pedicle, and caliber.
AB - Background: The present study investigates the vascular anatomy of the vastus lateralis motor nerve (VLMN) to be used as a vascularized nerve graft in facial nerve reconstruction. We evaluated the maximum length of the nerve that can be included in the flap and its vascular pedicle. In addition, we discuss its adequacy for use in early reconstruction of the facial nerve both as ipsilateral facial nerve reconstruction and as cross-facial nerve graft. Methods: Five fresh cadavers were used in this study. In all specimens, the VLMN and its vascular pedicle were dissected, photodocumented and measured using calipers. In addition, two vascularized VLMN were injected with a radiopaque contrast and underwent CT angiography and three dimensional reconstructions were scanned to illustrate the vascular supply of the nerve using OsiriX Software. Results: The VLMN was divided into two divisions, an oblique proximal and a descending distal, in 70% of the dissections with a mean maximal length of 8.4±4.5 cm for the oblique division and 15.03±3.87 cm for the descending division. The length of the oblique division, when present, was shorter than the length of the descending branch in all specimens. The mean length of the pedicle was 2.93±1.69 cm, and 3.27±1.49 cm until crossing the oblique and the descending division of the nerve respectively. The mean caliber of the nerve was 2.4±0.62 mm. Three-dimensional computed tomography angiography demonstrated perfusion throughout the entire VLMN by branches from the descending branch of the lateral femoral circumflex artery which ran parallel to the descending division of the VLMN. Additionally, we observed that technically it was possible to preserve the oblique branch of the VLMN. Conclusion: This study confirms that VLMN presents adequate anatomic features to be used as a vascularized nerve graft for facial nerve reconstruction in terms of length, pedicle, and caliber.
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U2 - 10.1002/micr.22311
DO - 10.1002/micr.22311
M3 - Article
C2 - 25141848
AN - SCOPUS:84923576686
SN - 0738-1085
VL - 35
SP - 135
EP - 139
JO - Microsurgery
JF - Microsurgery
IS - 2
ER -