Direct Neurotization: Past, Present, and Future Considerations.

Area of Science:

• Regenerative Medicine
• Neurosurgery
• Tissue Engineering

Background:

• Direct neurotization involves implanting nerve fascicles into target tissues like muscle, skin, or cornea.
• This technique has a history dating back to the early 1900s with documented experimental and clinical successes.

Purpose of the Study:

• To review the historical and current applications of direct neurotization.
• To explore future research and development in direct neurotization techniques.

Main Methods:

• Review of historical and current experimental and clinical reports on direct neurotization.
• Analysis of applications in sensory and motor neurotization, corneal sensation restoration, brachial plexus injury repair, tongue reinnervation, facial muscle reinnervation, and skin neurotization.

Main Results:

• Successful applications include restoring corneal sensation, repairing brachial plexus injuries, reestablishing tongue function, and reinnervating facial muscles.
• Recent advancements involve using acellular cadaveric nerve grafts for direct skin neurotization.

Conclusions:

• Direct neurotization is indicated when neural coaptation is not feasible, such as in neuromuscular junction damage or severe avulsion injuries.
• The technique's success and broad applicability suggest its potential as an adjunct treatment, not solely a salvage therapy.