Nerve donation saves man's life

When a nerve is injured, pain, numbness, and loss of sensation are common.

Fixing damaged nerves used to mean patients had to sacrifice another nerve from their body, but now there's an easier way.
Jesse Head doesn't take the little things like this for granted since doctors found a large benign tumor in his jaw.

“Just a general visit to the dentist and he found it on an x-ray," says Jesse.

The tumor was large and needed to be removed. But surgeons would also have to cut out Jesse's teeth, some of his jaw, and part of a large nerve.

Doctor John Zuniga says taking a graft from the leg used to be the only way to repair a damaged nerve, but it leads to permanent numbness in the leg.

“It's a nerve injury to fix a nerve injury," he says.

Instead, the doctor used part of a cadaver on Jesse. Avance is an engineered nerve from a deceased donor. It's placed between the damaged segments and nerves regenerate through tiny tubes.

“It's a scaffolding. It's like a biologic scaffolding," Doctor Zuniga explains.

It helped Jesse keep the sensation in his face and mouth. Today, he's almost back to normal.

Doctor Zuniga says he's seeing similar results with the FDA approved cadaver nerve as he sees when using a patient's own nerve.

He says the most common causes of facial nerve damage include wisdom teeth extractions, jaw reconstructive surgery, dental implants, and needle injection injuries.

RESEARCH SUMMARY

TOPIC: DEAD PEOPLE'S NERVES HELP THE LIVING
REPORT: MB # 3602

BACKGROUND: There are three types of nerves in the body, autonomic nerves, motor nerves, and sensory nerves. Autonomic nerves control the involuntary activities of the body, including blood pressure, heart rate, and digestion. Motor nerves control actions and movements by transferring information from the brain and spinal cord to the muscles. Sensory nerves relay information from the skin and muscles back to the spinal cord and brain. The information is then processed to let you feel pain and other sensations. There are more than 100 different types of nerve damage. (Source: www.webmd.com)

SYMPTOMS: Nerve damage can cause a wide range of symptoms. Symptoms will depend on the location and type of nerves that are affected. Damage could occur to nerves in the spinal cord and brain. It can also occur in peripheral nerves, which are located throughout the rest of the body.
* Autonomic nerve damage can cause sexual dysfunction, dry eyes and mouth, bladder dysfunction, constipation, too much sweating or too little sweating, lightheadedness, and inability to sense chest pain.
* Damage to motor nerves can cause muscle atrophy, twitching, paralysis, and weakness.
* Sensory nerve damage can cause sensitivity, pain, numbness, prickling or tingling, burning, and problems with positional awareness. (Source: www.webmd.com)

TREATMENT: In many cases, nerve damage cannot be cured. Usually the first goal of treatment is to address the underlying condition that is causing the nerve damage. This could mean: medications to treat autoimmune conditions, physical therapy or surgery to address compression or trauma to nerves, correcting nutritional deficiencies, regulating blood sugar levels for people with diabetes, or changing medications when drugs are causing the nerve damage. Medications can also be aimed at minimizing the nerve pain. (Source: www.webmd.com)

NEW TECHNOLOGY: Traditional methods of facial nerve reconstruction include autologous and cadaveric grafting; both can lead to patient morbidity. Autologous nerve grafts are the "gold standard" for superior regenerative capability, but are limited by the length and potential. Allogenic grafts from donors or cadavers have shown efficiency, but can require immunosuppression. (Source: http://www.ncbi.nlm.nih.gov/pubmed/21225804) AVANCE Nerve Graft is peripheral nerve allograft for the reconstruction of peripheral nerve discontinuities (severed nerve gaps) in order to guide and structurally support axonal regeneration across a nerve gap caused by traumatic injury or surgical intervention. It is a sterile extracellular matrix that is processed from human peripheral nerve tissue. The AVANCE Nerve Graft was developed by AxoGen by following the princlipe that the human body created the optimal nerve structure. The AVANCE Nerve Graft provides natural nerve structure of an autograft and the ease and availability of off-the-shelf products. AVANCE Nerve Graft is made up of bundles of small diameter tubes that are held together by an outer tube. It has been processed to remove noncellular and cellular factors like fat, cells, blood, axonal debris, and chondroitin sulfate proteoglycans while also preserving the three dimensional scaffold and structure of the peripheral nerve. It is offered in a variety of sizes with lengths between 15mm and 70mm and diameters up to 5mm, allowing the surgeon to choose the correct length for the relevant nerve gap. (Source: http://www.axogeninc.com/nerveGraft.html)

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FOR MORE INFORMATION, PLEASE CONTACT:

John R. Zuniga, DMD, MS, PhD
Robert V. Walker DDS Chair in Oral and Maxillofacial Surgery
Professor of Surgery
University of Texas Southwestern Medical Center in Dallas
(214) 648-3527
john.zuniga@utsouthwestern.edu

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Andrew McIntosh at amcintosh@ivanhoe.com.


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