Comparıson of the reconstructıon methods ın perıpheral nerve ınjurıes where nerve, vessel and cartılage grafts were used and the analysıs of a new technıque

SUMMARYThe peripheral nerve injuries mostly occur due to trauma as well as factors like tumors, inflammatory diseases, congenital deformities, infections and surgical interventions. The surgical procedure to be performed depends on the etiology and type of the injury and the anatomic region. The goal of the treatment is to minimize the loss of function due to motor and sensorial loss on the distal part of the injury. Because the complete nerve regeneration independently from the cause of the injury does not occur, the abnormal nerve regeneration usually results in functional loss and pain.The optimal treatment of the peripheral nerve injuries is to provide the adequate coaptation of proximal and distal sides without tension, preventing the neurotropic factors in the repair line. Although the gold standard for the nerve defects is autograft use, because of the denervation of the donor site, scarring and neuroma formation, many studies have been conducted for the repair of peripheral nerve injuries aiming to obtain simpler methods to offer better functional results with less morbidity.In our study, a defect with 1 cm of length on the sciatic nerve of the rat was created. In Group 1: autograft, Group 2: allogeneic aorta graft, Group 3: diced cartilage graft in allogeneic aorta graft and Group 4: tubularized cartilage were used and in particular, the effects of cartilage tissue in nerve regeneration were evaluated by functional and histomorphological methods.Group 1, where the repair was performed with autograft use was evaluated as the most similar group to the control group. There was not a statistically significant difference in terms of myelination and schwann cell rates between Group 2 where allogeneic aorta graft was used and Group 3 where diced cartilage in allogeneic aorta graft was used. In Group 4, myelination and schwann cell formation were observed, however they were scattered and irregular and it was supposed to be due to increased fibrosis.In all of the groups, nerve regeneration in various rates were showed both functionally and histomorphologically. This study shows that cartilage tissue has promoting effects in nerve regeneration.