Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to plain ANAs as the results with ANAs are still unpredictable and not very successful. The authors selected 40 papers and categorised them based on animal model, enhancing cell types, decellularisation method and neuroregenerative test. Their meta-analysis reveals that cell-enhanced ANAs promoted nerve regeneration identical to autografts in several studies. In the remainder of the studies, either autografts or cell-enhanced ANAs over-performed over each other. The authors conclude that improvements in ANAs with further refinement may lead to ANAs providing comparable or even better results than autografts. They recommend further research for developing enhanced ANAs as alternatives to autograft. This is of special interest for surgeons performing facial nerve grafting after parotidectomy, removal of facial schwannomas or vestibular schwannomas.
Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts
Reviewed by Gauri Mankekar
Cell-enhanced acellular nerve allografts for peripheral nerve reconstruction: a systematic review and a meta-analysis of the literature.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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