Anatomical and functional justification of the use of supraorbital and supratrochlear nerves for direct corneal neurotization in patients with combined pathology of the trigeminal and other cranial nerves

S.B. Butsan

National Medical Research Center of Dentistry and Maxillofacial Surgery

M.B. Gushchina

Central Research Institute of Dentistry and Maxillofacial Surgery;
Fyodorov Intersectoral Scientific and Technical Complex “Eye Microsurgery”

V.Yu. Sergeeva

Central Research Institute of Dentistry and Maxillofacial Surgery

K.S. Salikhov

National Medical Research Center of Dentistry and Maxillofacial Surgery

A.V. Tereshchenko

Kaluga branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

A.G. Nadtochiy

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0002-3268-0982

A.E. Khodyachiy

National Medical Research center for Stomatology and Maxillofacial surgery

E.V. Erokhina

Kaluga Branch of the S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery»

S.K. Demianchenko

Fyodorov Intersectoral Scientific and Technical Complex “Eye Microsurgery”

Anatomical and functional justification of the use of supraorbital and supratrochlear nerves for direct corneal neurotization in patients with combined pathology of the trigeminal and other cranial nerves

Authors:

S.B. Butsan, M.B. Gushchina, V.Yu. Sergeeva, K.S. Salikhov, A.V. Tereshchenko, A.G. Nadtochiy, A.E. Khodyachiy, E.V. Erokhina, S.K. Demianchenko

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2022;(1): 41‑48

DOI: 10.17116/plast.hirurgia202201141

Downloaded: 69

To cite this article:

Butsan SB, Gushchina MB, Sergeeva VYu, Salikhov KS, Tereshchenko AV, Nadtochiy AG, Khodyachiy AE, Erokhina EV, Demianchenko SK. Anatomical and functional justification of the use of supraorbital and supratrochlear nerves for direct corneal neurotization in patients with combined pathology of the trigeminal and other cranial nerves. Plastic Surgery and Aesthetic Medicine. 2022;(1):41‑48. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202201141

Доказательная гастроэнтерология: pro et contra

Актуальные вопросы педиатрической практики

Использование инфографики авторами научных работ

Close metadata

RELEVANCE

Damage of the trigeminal and facial nerves leads the protective function of the eyelids is disrupted and neurotrophic keratopathy which can lead the visual loss.

OBJECTIVE

The study the topographic and anatomical features of the donor zone and the functional results of direct corneal neurotization.

MATERIAL AND METHODS

10 direct corneal neurotisations were performed using supraorbital and supratrochlear nerves. The indication for the procedure was a decrease of blink reflex and corneal sensitivity. The effectiveness of the procedure was assessed by the dynamics of sensitivity and photoregistration of the cornea. Donor damage was assessed by the dynamics of skin sensitivity before and after surgery.

RESULTS AND DISCUSSION

3-5 nerve fascicules 6-12 cm long of the supraorbital and supratrochlear nerves were used. Followed-up 4 to 30 months. At the same time, against the background of the absence of relapses of neurotrophic keratopathy, complete recovery was observed in 6 and a significant increase in corneal sensitivity in 4 patients. There was an improvement in the transparency of the cornea, a reduction in the area and intensity of opacities. There was a slight decrease in skin sensitivity was noted on the donor side.

CONCLUSION

Direct corneal neurotization in all patients provided positive dynamics, consisting in restoring corneal sensitivity, reducing the area and intensity of the eyesore, partially restoring the sensitivity of the eyelid skin on the affected side without significant donor damage.

Keywords:

facial nerve

paralytic lagophthalmos

diverting nerve

converging paralytic strabismus

neurotrophic keratopathy

corneal innervation

corneal thorn

corneal sensitivity

esthesiometry

Authors:

S.B. Butsan

National Medical Research Center of Dentistry and Maxillofacial Surgery

M.B. Gushchina

Central Research Institute of Dentistry and Maxillofacial Surgery;
Fyodorov Intersectoral Scientific and Technical Complex “Eye Microsurgery”

V.Yu. Sergeeva

Central Research Institute of Dentistry and Maxillofacial Surgery

K.S. Salikhov

National Medical Research Center of Dentistry and Maxillofacial Surgery

A.V. Tereshchenko

Kaluga branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

A.G. Nadtochiy

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0002-3268-0982

A.E. Khodyachiy

National Medical Research center for Stomatology and Maxillofacial surgery

E.V. Erokhina

Kaluga Branch of the S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery»

S.K. Demianchenko

Fyodorov Intersectoral Scientific and Technical Complex “Eye Microsurgery”

Received:

03.11.2021

Accepted:

10.12.2021

List of references:

Stupak VV, Pendyurin IV. Rezul’taty khirurgicheskogo lecheniya bol’shikh i gigantskikh nevrinom slukhovogo nerva. Sovremennye problemy nauki i obrazovaniya. 2017;5. (In Russ.). Accessed February 10, 2021. https://science-education.ru/ru/article/view?id=26993
Preston DC, Shapiro BE. Facial and Trigeminal Neuropathy. Electromyography and Neuromuscular Disorders (Third Edition). 2013;372-383. https://doi.org/10.1016/b978-1-4557-2672-1.00025-8
Dua HS, Said DG, Messmer EM, Rolando M, Benitez-del-Castillo JM, Hossain PN, Baudouin C. Neurotrophic keratopathy. Progress in Retinal and Eye Research. 2018;66:107-131. https://doi.org/10.1016/j.preteyeres.2018.04.003
Lambiase A, Sacchetti M, Mastropasqua A, Bonini S. Corneal Changes in Neurosurgically Induced Neurotrophic Keratitis. JAMA Ophthalmology. 2013;131(12):1547-1553. https://doi.org/10.1001/jamaophthalmol.2013.5064
Arzhantsev PZ, Vissarionov VA, Davydov BN, et al. Reconstructive surgery of soft tissues of the maxillofacial region. A guide for physicians. Nerobeyev AI, Plotnikov NA, eds. M.: Meditsina; 1997. (In Russ.).
Shurgaya TsM. Khirurgicheskij algoritm lecheniya bol’nykh s litsevymi paralichami: Diss. ... d-ra med. nauk: 14.00.21. M.: Stomatologiya; 1996:35. (In Russ.).
Nerobeyev AI, Visaitova ZYu, Somova MM, Salikhov K.C. Porazheniya litsevogo nerva: o chem vrach dolzhen rasskazat’ patsientu. Vestnik esteticheskoj meditsiny. 2013;12(4). (In Russ.). Accessed February 10, 2021. https://www.cniis.ru/downloads/files/poragenie%20lizevogo%20nerva.PDF
Gileva KS, Botoev SR. Rekonstruktsiya nizhneal’veolyarnogo nerva pri rezektsiyakh nizhnej chelyusti po povodu dobrokachestvennykh opukholej. IX National Congress “Plastic surgery, aesthetic medicine and cosmetology”, December 10-12, 2020. Moscow. Collection of theses. 2020:91. (In Russ.). Accessed February 10, 2021. https://online.plastsur.ru/images/ph_tezis.pdf
Terzis JK, Dryer MM, Bodner BI. Corneal neurotization: A novel solution to neurotrophic keratopathy. Plast Reconstr Surg. 2009;123(1):112-120. https://doi.org/10.1097/PRS.0b013e3181904d3a
Allevi F, Fogagnolo P, Rossetti L, Biglioli F. Eyelid reanimation, neurotisation, and transplantation of the cornea in a patient with facial palsy. BMJ Case Rep. 2014;2014:1-3. https://doi.org/10.1136/bcr-2014-205372
Jacinto F, Espana E, Padilla M, Ahmad A, Leyngold I. Ipsilateral supraorbital nerve transfer in a case of recalcitrant neurotrophic keratopathy with an intact ipsilateral frontal nerve: A novel surgical technique. Am J Ophthalmol Case Rep. 2016;4:14-17. https://doi.org/10.1016/j.ajoc.2016.07.001
Elbaz U, Bains R, Zuker RM, Borschel GH, Ali A. Restoration of corneal sensation with regional nerve transfers and nerve grafts: A new approach to a difficult problem. JAMA Ophthalmol. 2014;132:1289-1295. https://doi.org/10.1001/jamaophthalmol.2014.2316
Leyngold IM, Weller C, Leyngold M, Tabor M. Endoscopic corneal neurotization: technique and initial experience. Ophthalm Plast Reconstr Surg. 2018;34(1):82-85. https://doi.org/10.1097/IOP.0000000000001023
Györi E, Tzou C-HJ, Weninger WJ, Reissig L, Schmidt-Erfurth U, Radtke C, et al. Axon numbers and landmarks of trigeminal donor nerves for corneal neurotization. PLoS One. 2018;13(10):e0206642. https://doi.org/10.1371/journal.pone.0206642
Grusha YaO, Novikov ML, Danilov SS, Fettser EI, Karapetyan AS. Neurotization of the cornea as pathogenically targeted method of treating neurotrophic keratitis in patients with facial paralysis. The Russian Annals of Ophthalmology. 2020;136(5):52-57. (In Russ.). https://doi.org/10.17116/oftalma202013605152
Domeshek LF, Hunter DA, Santosa K, Couch SM, Ali A, Borschel GH, Snyder-Warwick AK. Anatomic characteristics of supraorbital and supratrochlear nerves relevant to their use in corneal neurotization. Eye. 2019;33: 398-403. Published: September 27, 2018. https://doi.org/10.1038/s41433-018-0222-0
Sergeeva VYu, Butsan SB, Salikhov KS, Gushchina MB. Patent RF na izobretenie №2722998/05.06.20. Sposob vosstanovleniya trofiki rogovitsy glaza pri nejrotroficheskoj keratopatii. (In Russ.). Accessed February 10, 2021. https://www1.fips.ru/ofpstorage/Doc/IZPM/RUNWC1/000/000/002/722/998/%D0%98%D0%97-02722998-00001/document.pdf

Close metadata