Advertisement

Functional Recovery Following an End to Side Neurorrhaphy of the Accessory Nerve to the Suprascapular Nerve: Case Report

  • 86 Accesses

  • 10 Citations

Abstract

The use of end-to-side neurrorhaphy remains a controversial topic in peripheral nerve surgery. The authors report the long-term functional outcome following a modified end-to-side motor reinnervation using the spinal accessory to innervate the suprascapular nerve following a C5 to C6 avulsion injury. Additionally, functional outcomes of an end-to-end neurotization of the triceps branch to the axillary nerve and double fascicular transfer of the ulnar and medial nerve to the biceps and brachialis are presented. Excellent functional recoveries are found in respect to shoulder abduction and flexion and elbow flexion.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Figure 1
Figure 2
Figure 3

References

  1. 1.

    Akeda K, et al. Regenerating axons emerge far proximal to the coaptation site in end-to-side nerve coaptation without a perineurial window using a T-shaped chamber. Plast Reconstr Surg. 2006;117:1194–203. discussion 1204-1195.

  2. 2.

    Asaoka K, Sawamura Y. Hypoglossal-facial nerve side-to-end anastomosis. J Neurosurg. 1999;91:163–4.

  3. 3.

    Asaoka K, Sawamura Y, Nagashima M, Fukushima T. Surgical anatomy for direct hypoglossal-facial nerve side-to-end "anastomosis". J Neurosurg. 1999;91:268–75.

  4. 4.

    Bertelli JA, Ghizoni MF. Nerve repair by end-to-side coaptation or fascicular transfer: a clinical study. J Reconstr Microsurg. 2003;19:313–18.

  5. 5.

    Bontioti E, Kanje M, Lundborg G, Dahlin LB. End-to-side nerve repair in the upper extremity of rat. J Peripher Nerv Syst. 2005;10:58–68.

  6. 6.

    Brenner MJ, Dvali L, Hunter DA, Myckatyn TM, Mackinnon SE. Motor neuron regeneration through end-to-side repairs is a function of donor nerve axotomy. Plast Reconstr Surg. 2007;120:215–23.

  7. 7.

    Colbert SH, Mackinnon S. Posterior approach for double nerve transfer for restoration of shoulder function in upper brachial plexus palsy. Hand (N Y). 2006;1:71–7.

  8. 8.

    Dvali LT, Myckatyn TM. End-to-side nerve repair: review of the literature and clinical indications. Hand Clin. 2008;24:455–60.

  9. 9.

    Godefroy WP, Malessy MJ, Tromp AA, van der Mey AG. Intratemporal facial nerve transfer with direct coaptation to the hypoglossal nerve. Otol Neurotol. 2007;28:546–50.

  10. 10.

    Goheen-Robillard B, Myckatyn TM, Mackinnon SE, Hunter DA. End-to-side neurorrhaphy and lateral axonal sprouting in a long graft rat model. Laryngoscope. 2002;112:899–905.

  11. 11.

    Hayashi A, et al. Collateral sprouting occurs following end-to-side neurorrhaphy. Plast Reconstr Surg. 2004;114:129–37.

  12. 12.

    Hayashi A, et al. Axotomy or compression is required for axonal sprouting following end-to-side neurorrhaphy. Exp Neurol. 2008;211:539–50.

  13. 13.

    Hess JR, Brenner MJ, Myckatyn TM, Hunter DA, Mackinnon SE. Influence of aging on regeneration in end-to-side neurorrhaphy. Ann Plast Surg. 2006;57:217–22.

  14. 14.

    Liverneaux PA, Diaz LC, Beaulieu JY, Durand S, Oberlin C. Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plast Reconstr Surg. 2006;117:915–19.

  15. 15.

    Lundborg G, Zhao Q, Kanje M, Danielsen N, Kerns JM. Can sensory and motor collateral sprouting be induced from intact peripheral nerve by end-to-side anastomosis? J Hand Surg Br. 1994;19:277–82.

  16. 16.

    Mackinnon SE. Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plast Reconstr Surg. 2006;118:1273. author reply 1274.

  17. 17.

    Mackinnon SE, Colbert SH. Nerve transfers in the hand and upper extremity surgery. Tech Hand Up Extrem Surg. 2008;12:20–33.

  18. 18.

    Mackinnon SE, Roque B, Tung TH. Median to radial nerve transfer for treatment of radial nerve palsy. case report. J Neurosurg. 2007;107:666–71.

  19. 19.

    Noah EM, Williams A, Fortes W, Terzis JK. A new animal model to investigate axonal sprouting after end-to-side neurorrhaphy. J Reconstr Microsurg. 1997;13:317–25.

  20. 20.

    Noah EM, Williams A, Jorgenson C, Skoulis TG, Terzis JK. 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.

  21. 21.

    Novak CB, Mackinnon SE. Treatment of a proximal accessory nerve injury with nerve transfer. Laryngoscope. 2004;114:1482–4.

  22. 22.

    Novak CB, Mackinnon SE, Tung TH. Patient outcome following a thoracodorsal to musculocutaneous nerve transfer for reconstruction of elbow flexion. Br J Plast Surg. 2002;55:416–19.

  23. 23.

    Okajima S, Terzis JK. Ultrastructure of early axonal regeneration in an end-to-side neurorrhaphy model. J Reconstr Microsurg. 2000;16:313–23. discussion 323-316.

  24. 24.

    Papalia I, Geuna S, D'Alcontres FS, Tos P. Origin and history of end-to-side neurorrhaphy. Microsurgery. 2007;27:56–61.

  25. 25.

    Ray WZ, Mackinnon SE. Management of nerve gaps: Autografts, allografts, nerve transfers, and end-to-side neurorrhaphy. Exp Neurol (2009), doi:10.1016/j.expneurol.2009.03.031.

  26. 26.

    Rovak JM, Cederna PS, Kuzon WM Jr. Terminolateral neurorrhaphy: a review of the literature. J Reconstr Microsurg. 2001;17:615–24.

  27. 27.

    Singh N, Robertson B, Dellon L. Use of an innervated tongue flap to rehabilitate the tongue after hypoglossal-to-facial nerve transfer. Plast Reconstr Surg. 2002;109:2439–42.

  28. 28.

    Tarasidis G, et al. End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model. Ann Otol Rhinol Laryngol. 1997;106:506–12.

  29. 29.

    Tarasidis G, et al. End-to-side neurorraphy: a long-term study of neural regeneration in a rat model. Otolaryngol Head Neck Surg. 1998;119:337–41.

  30. 30.

    Tung TH, Liu DZ, Mackinnon SE. Nerve transfer for elbow flexion in radiation-induced brachial plexopathy: a case report. Hand (N Y). 2009;4:123–8.

  31. 31.

    Ueda K, et al. Combination of hypoglossal-facial nerve jump graft by end-to-side neurorrhaphy and cross-face nerve graft for the treatment of facial paralysis. J Reconstr Microsurg. 2007;23:181–7.

  32. 32.

    Venail F, et al. Outcomes and complications of direct end-to-side facial-hypoglossal nerve anastomosis according to the modified May technique. J Neurosurg. 2009;110:786–91.

  33. 33.

    Viterbo F, Trindade JC, Hoshino K, Mazzoni A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats. Br J Plast Surg. 1994;47:75–80.

  34. 34.

    Voche P, Ouattara D. End-to-side neurorrhaphy for defects of palmar sensory digital nerves. Br J Plast Surg. 2005;58:239–44.

  35. 35.

    Zhang F, Fischer KA. End-to-side neurorrhaphy. Microsurgery. 2002;22:122–7.

  36. 36.

    Zhang Z, et al. Repair of the main nerve trunk of the upper limb with end-to-side neurorrhaphy: an experimental study in rabbits. Microsurgery. 2006;26:245–52.

  37. 37.

    Zhu QT, Zhu JK, Chen GY. Location of collateral sprouting of donor nerve following end-to-side neurorrhaphy. Muscle Nerve. 2008;38:1506–9.

Download references

Author information

Correspondence to Susan E. Mackinnon.

Electronic Supplementary materials

(WMV 2355 kb)

(WMV 10354 kb)

Video 1

(WMV 2355 kb)

Video 2

(WMV 10354 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ray, W.Z., Kasukurthi, R., Yee, A. et al. Functional Recovery Following an End to Side Neurorrhaphy of the Accessory Nerve to the Suprascapular Nerve: Case Report. HAND 5, 313–317 (2010). https://doi.org/10.1007/s11552-009-9242-3

Download citation

Keywords

  • End-to-side
  • Neurorrhaphy
  • Collateral sprouting
  • Neurotization
  • Avulsion