Cadaveric Nerve Allograft: Single Center's Experience in a Variety of Peripheral Nerve Injuries

The purpose of this study is to report a single center's experience with cadaveric nerve allograft (CNA) for functional restoration after traumatic nerve injuries including the head and neck region. Sixteen patients were included in the current study. Ages ranged from 5 to 62 years, with a mean age of 35 years. The main indication for the use of CNA was nerve gaps of at least 10 mm in which both the proximal and distal stumps of the injured nerves were available. Only allografts from cadavers were used, and none of the patients underwent immunosuppressive treatment. Denervation time average was 12 weeks, with an average gap length of 65 mm. Most cases were located in the upper extremity (73%) and 80% were secondary to trauma. Most nerves involved were sensory, followed by mixed nerves and 2 patients with facial paralysis. Sensory recovery was graded as good and excellent in 91.7%. Motor recovery was graded as good in 33%. The results of the current study suggest that peripheral nerve injuries can successfully be treated by the use of CNA and may be used in larger nerve gaps and for unconventional uses, although caution should be used specifically in mixed or motor nerves and high level of injury. Avoiding donor site morbidity, minimizing operative time, and availability are the most important advantages of using CNA over autologous nerve grafts.