Repair of the musculocutaneous nerve using the vagus nerve as donor by helicoid end‐to‐side technique: an experimental study in rats
Neurotization is a viable option in shoulder and elbow reanimation following C5 and C6 root avulsion or rupture. To date, some of the most frequently used nerve sources include the phrenic nerve, spinal accessory nerve, cross C7 nerve, and intercostal nerves (Allieu and Cenac, 1988; Songcharoen et al., 1996; Gu et al., 1989; Gu, et al., 1989b; Chuang et al., 1995; Krakauer and Wood, 1994). This diversity of nerve source options affords the ability to tailor donor selection to the unique needs of the patient. Despite this, each choice brings with it a host of differing limitations, including inconsistent results, demographic contraindications, and the associated risks of donor nerve sacrifice (Alnot et al., 1998; Terzis and Papakonstantinou, 2000). In light of these limitations, there continues to be great impetus for the discovery of new repair methods and nerve transfer sources.
The vagus nerve (VN) is the longest cranial nerve, containing both motor and sensory fibers, and has a wider distribution than any other nerve in the human body. Because VN is a voluntary nerve and contains many parasympathetic nerve fibers, despite its proximity to the brachial plexus, it has never been investigated as a potential source for nerve transfer in BPI. The VN possesses a unique set of qualities that prompted our lab to investigate. Namely, it is easy to identify and dissect, has a wider diameter than many of the currently utilized sources, and is almost always available in surviving victims. Taking this into consideration, we performed this study with the intention of investigating if the VN could serve as a viable source for nerve transfer in total root avulsion brachial plexus injury.