Clin Exp Otorhinolaryngol.  2018 Sep;11(3):174-180. 10.21053/ceo.2017.00864.

Evaluation of the Possible Neurotoxic Effect of the Bone Cement on the Facial Nerve: An Experimental Study

• Kökten N
• EÄŸilmez O
• KalcıoÄŸlu MT
• Baran M
• Ekici AI

• KMID: 2429006
• DOI: http://doi.org/10.21053/ceo.2017.00864

Abstract

OBJECTIVES
To investigate neurotoxic effect of bone cement (BC) on facial nerve by using electrophysiological and histopathological methods.
METHODS
This study included 20 male albino Wistar rats, divided into four equal groups. Group A was designed as the control group, while group B was sham group. In the group C, BC solution was dropped onto the facial nerve trunks of rats and washed with physiological saline after 5 seconds. In the group D, BC solution was dropped onto the facial nerve trunks of rats and after allowing 5 minutes to dry, wounds were closed. Pre- and postoperative (on 4th week) evoked electromyography (EMG) measurements were done. For histopathological assessments, the rats were euthanized and tissue samples of facial nerve and surrounding areas were collected.
RESULTS
According to the wave amplitude levels of evoked EMG, postoperative amplitude levels of group D were significantly decreased, compared to preoperative amplitude levels (P=0.043). We found no statistically significant difference in inflammation among the groups. In none of the groups, foreign body reaction and granulation tissue were not detected in any of the groups. In addition, degeneration in axon, myelin, or perineural nets was not detected in any of the groups.
CONCLUSION
This study results suggest that BC has no direct toxicity on facial nerve, while it has indirect effects, by decreasing amplitude. Therefore, we conclude that direct contact of BC with nerve should be avoided, and the area should be cleaned by aspiration or washing with physiological saline in case of contact.

Keyword

Bone Cements; Rats; Electromyography; Neurotoxicity; Facial Nerve

MeSH Terms

Animals
Axons
Bone Cements
Electromyography
Facial Nerve*
Foreign-Body Reaction
Granulation Tissue
Humans
Inflammation
Male
Myelin Sheath
Rats
Rats, Wistar
Wounds and Injuries
Bone Cements

Figure

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  Fig. 1. Group D: bone cement was dropped and kept for 5 minutes drying.

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  Fig. 2. Histopathologic section of the facial nerves and surrounding tissues of rats in all groups: H&E and s-100 stain (left and right, respectively), scale bar indicates 100 μm. The section is from (A) group A (control), (B) group B (sham), (C) group C (bone cement [BC] is applied for 5 seconds and cleaned), and (D) from group D (BC was applied and kept for 5 minutes drying). There was no axonal degeneration in all figures. Perineural sheath and myelin structure layout were also regular (shown with arrows), but there was an inflammation of muscle and myositis in a rat tissue of group D (shown with asterisk).

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