Vojnosanitetski pregled 2023 Volume 80, Issue 4, Pages: 349-355
https://doi.org/10.2298/VSP171208048G
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Assessment of efficacy of platelet-rich plasma application in regeneration of the facial nerve in rabbits
Gardašević Milka F. (Military Medical Academy, Clinic for Maxillofacial Surgery, Belgrade, Serbia)
Petković-Ćurčin Aleksandra (Military Medical Academy, Institute for Medical Research, Belgrade, Serbia)
Vojvodić Danilo V. 
(Military Medical Academy, Institute for Medical Research, Belgrade, Serbia)
Marjanović Uroš (Military Medical Academy, Clinic for Maxillofacial Surgery, Belgrade, Serbia), marjanovic.u@gmail.com
Đurđević Dragan (Military Medical Academy, Institute for Medical Research, Belgrade, Serbia)
Jović Saša (Military Medical Academy, Clinic for Maxillofacial Surgery, Belgrade, Serbia)
Vulović Dejan (University Clinical Center of Kragujevac, Center for Plastic Surgery, Kragujevac, Serbia)
Matijević Stevo (Military Medical Academy, Clinic of Dentistry, Department of Oral Surgery, Belgrade, Serbia)
Background/Aim. The injuries of the facial nerve lead to paralysis of the mimic musculature, which is conditioned by functional disorders accompanied by deformity of varying degrees depending on the intensity and location of the injury. Surgical treatment is a method of choice to treat an injured nerve. Injuries in the parotid lodge area are repaired by direct neurosuture in combination with platelet-rich plasma (PRP). Methods. The experimental study was carried out on 48 chinchilla male rabbits (Oryctolagus cuniculus), of about the same weight (2,500–3,000 gr), aged between 3 and 4 months in two surgical stages, in two different periods – six and ten weeks after the first surgical procedure. The animals were divided into four groups: Group I (suture); Group II [suture and fibrin glue (FG)]; Group III (suture and PRP); Group IV (sutures, FG, and PRP). Each group had two subgroups based on the duration of the experiment (six and ten weeks). A part of the dissected nerve in the length of 5 mm was subjected to histologic verification, where the number of axons and Schwann cells was determined and expressed numerically based on the histological sample of the tissue of the observed nerve. The extent of the presence of connective tissue and the degree of neo-vascularisation is shown by the description of histological samples by grades (connective tissue 1-4, neovascularisation 1-3). Results. Our results showed that all parameters of re-generation of damaged nerve showed a significantly higher regeneration efficiency after six and ten weeks of intervention in groups treated with PRP therapy with or without using FG. Conclusion. The use of PRP and the stimulating effect of activated growth factors results in the regeneration of the facial nerve in the sense of replication of the Schwann cells and the number of axons, with a high degree of neovascularization and minimal proliferation of connective tissue, which histologically corresponds to a healthy nerve.
Keywords: animals, laboratory, facial nerve injuries, histological techniques, nerve regeneration, platelet rich plasma, rabbit
Show references
Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve 1990; 13(9): 771-84.
Jović N. Facial paralysis: etiology, diagnosis and treatment. Belgrade: Vojnomedicinska Akademija; 2004. (Serbian)
Klintworth N, Zenk J, Koch M, Iro H. Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function. Laryngoscope 2010; 120(3): 484-90.
Asma A, Marina MB, Mazita A, Fadzilah I, Mazlina S, Saim L. Iatrogenic facial nerve palsy: lessons to learn. Singapore Med J 2009; 50(12): 1154-7.
Davis RE, Telischi FF. Traumatic facial nerve injuries: review of diagnosis and treatment. J Craniomaxillofac Trauma 1995; 1(3): 30-41.
Gordin EA, Daniero JJ, Krein H, Boon MS. Parotid gland trauma. Facial Plast Surg 2010; 26(6): 504-10.
Gierek T, Majzel K, Slaska-Kaspera A, Gwóźdź-Jezierska M. The results of surgical treatment of the facial nerve paralysis. Otolaryngol Pol 2007; 61(4): 383-6. (Polish)
Gavron JP, Clemis JD. Hypoglossal-facial nerve anastomosis: a review of forty cases caused by facial nerve injuries in the posterior fossa. Laryngoscope 1984; 94(11): 1447-50.
Conley J, Baker DC. Hypoglossal-facial nerve anastomosis for reinnervation of the paralyzed face. Plast Reconstr Surg 1979; 63(1): 63-72.
Messora MR, Hitomi Nagata MJ, Chaves Furlaneto FA, Menegati Dornelles RC, Mogami Bomfim SR, Tatiana Miranda Deliberador, et al. A standardized research protocol for plateletrich plasma (PRP) preparation in rats. RSBO 2011; 8(3): 299-304.
Ornelas L, Padilla L, Di Silvio M, Schalch P, Esperante S, Infante RL, et al. Fibrin glue: an alternative technique for nerve coaptation--Part II. Nerve regeneration and histomorphometric assessment. J Reconstr Microsurg 2006; 22(2): 123-8.
Izquierdo O, Alvarez R, Aparicio P, Castellanos J, Dominguez E. Effect of plateletrich plasma on peripheral nerve regeneration, model in rat. J Bone Joint Surg 2011; 93: 132-3.
Küçük L, Günay H, Erbaş O, Küçük Ü, Atamaz F, Coşkunol E. Effects of plateletrich plasma on nerve regeneration in a rat model. Acta Orthop Traumatol Turc 2014; 48(4): 449-54.
Duka M, Lazić Z, Bubalo M. Effect of local administration of plateletrich plasma and guided tissue regeneration on the level of bone resorption in early dental implant insertion Vojnosanit Pregl 2008; 65(6): 462-8. (Serbian)
Giorgetti M, Siciliano G. Plateletrich plasma: the role in neural repair. Neural Regen Res 2015; 10(12): 1920-1.
Lichtenfels M, Colomé L, Sebben AD, Braga-Silva J. Effect of Platelet Rich Plasma and Platelet Rich Fibrin on sciatic nerve regeneration in a rat model. Microsurgery 2013; 33(5): 383-90.
Abbasipour-Dalivand S, Mohammadi R, Mohammadi V. Effects of Local Administration of Platelet Rich Plasma on Functional Recovery after Bridging Sciatic Nerve Defect Using Silicone Rubber Chamber; An Experimental Study. Bull Emerg Trauma 2015; 3(1): 1-7.
Zheng C, Zhu Q, Liu X, Huang X, He C, Jiang L, Q, et al. Improved peripheral nerve regeneration using acellular nerve allografts loaded with plateletrich plasma. Tissue Eng Part A 2014; 20(23-24): 3228-40.
Fatemi MJ, Pakfetrat F, Akhoondinasab MRA, Mansouri K, Moosavi SJ, Hosseini SA, et al. The effect of subepineural platelet- rich plasma (PRP) on regeneration of the sciatic nerve in a rat model. Tehran Univ Med J 2016; 73(10): 693-9.
Giannessi E, Coli A, Stornelli MR, Miragliotta V, Pirone A, Lenzi C, et al. An autologously generated platelet-rich plasma suturable membrane may enhance peripheral nerve regeneration after neurorraphy in an acute injury model of sciatic nerve neurotmesis. J Reconstr Microsurg 2014; 30(9): 617-26.
Sabongi RG, De Rizzo LA, Fernandes M, Valente SG, Gomes dos Santos JB, Faloppa F, et al. Nerve regeneration: is there an alternative to nervous graft? J Reconstr Microsurg 2014; 30(9): 607-16.
Sánchez M, Anitua E, Delgado D, Sanchez P, Prado R, Goiriena JJ, et al. A new strategy to tackle severe knee osteoarthritis: Combination of intra-articular and intraosseous injections of Platelet Rich Plasma. Expert Opin Biol Ther 2016; 16(5): 627-43.
Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, et al. Plateletrich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc 2012; 20(10): 2082-91.
Filardo G, Kon E, Roffi A, Di Matteo B, Merli ML, Marcacci M. Platelet-rich plasma: why intraarticular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc 2015; 23(9): 2459-74.
de Almeida AM, Demange MK, Sobrado MF, Rodrigues MB, Pedrinelli A, Hernandez AJ. Patellar tendon healing with platelet-rich plasma: a prospective randomized controlled trial. Am J Sports Med 2012; 40(6): 1282-8.
Taschieri S, Testori T, Corbella S, Weinstein R, Francetti L, Di Giancamillo A, et al. Platelet-Rich Plasma and Deproteinized Bovine Bone Matrix in Maxillary Sinus Lift Surgery: A Split-Mouth Histomorphometric Evaluation. Implant Dent 2015; 24(5): 592-7.
Kumar KA, Rao JB, Pavan Kumar B, Mohan AP, Patil K, Parimala K. A prospective study involving the use of platelet rich plasma in enhancing the uptake of bone grafts in the oral and maxillofacial region. J Maxillofac Oral Surg 2013; 12(4): 387-94.
Eskan MA, Greenwell H, Hill M, Morton D, Vidal R, Shumway B, et al. Platelet-rich plasma-assisted guided bone regeneration for ridge augmentation: a randomized, controlled clinical trial. J Periodontol 2014; 85(5): 661-8.
Daif ET. Effect of autologous platelet-rich plasma on bone regeneration in mandibular fractures. Dent Traumatol 2013; 29(5): 399-403.
Menezes DJ, Shibli JA, Gehrke SA, Beder AM, Sendyk WR. Effect of platelet-rich plasma in alveolar distraction osteogenesis: a controlled clinical trial. Br J Oral Maxillofac Surg 2016; 54(1): 83-7.
Del Fabbro M, Corbella S, Taschieri S, Francetti L, Weinstein R. Autologous platelet concentrate for post-extraction socket healing: a systematic review. Eur J Oral Implantol 2014; 7(4): 333-44.