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    Comparison of peripheral nerve repair using ethylcyanoacrylate and conventional suture technique in a rat sciatic nerve injury model
    (2020) Atam, Camettin; Orhan, Zafer; Toplu, Gaye; Serin, Merdan; Karaduman, Zekeriya Okan; Öztürk, Ayhan
    Objective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate orconventional microsuture technique in a rat peripheral nerve injury model.Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomlydivided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventionalmicrosuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No furtherintervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumaticnylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography(EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conductionvelocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolardegeneration, fibrosis, and foreign body reaction histopathologically.Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2(1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3(2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCVwas 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant differencebetween groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathologicalevaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obviousdifference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2,and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reactionscore was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743).Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathologicalresults as compared to the conventional microsuture repair.
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    Lefort 1 Osteotomy Study of Maxillary Bone in Caprine Skull Model: Comparison of Different Osteotomy Techniques (Piezo Versus Lindemann Bur Versus Manual Chisel)
    (Lippincott Williams & Wilkins, 2024) Serin, Merdan; Altinel, Dincer; Toplu, Gaye; Rakici, Ibrahim Taskin; Toplu, Selcuk Goksel
    Objective:In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model. Methods:Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue. Results:The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (+/- 0.7), 3.38 (+/- 1.49), and 1.39 (+/- 0.3) mm, respectively (P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (+/- 1.4), 1.6 (+/- 0.3), and 0.6 (+/- 0.5), respectively (P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques. Conclusion:We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.