• Elisangela Jeronymo Stipp-Brambilla, Fausto Viterbo, Daniel Labbé, José Antonio Garbino, and Maíra Miranda Bernardelli.
• Department of Surgery and Orthopedics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São Paulo, Brazil. elistipp@fmb.unesp.br
• Sao Paulo Med J. 2012 Jan 1; 130 (6): 373379373-9.

Context And ObjectiveOne of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation.Design And SettingExperimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp.MethodsOne hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy.ResultsOne hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred.ConclusionThese findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned.

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