• Open Access

Improved facial nerve identification with novel fluorescently labeled probe

Authors

  • Amy P. Wu MD,

    1. From the Division of Otolaryngology—Head and Neck Surgery, , UCSD, San Diego, California, U.S.A.
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  • Michael A. Whitney PhD,

    1. Department of Pharmacology , UCSD, San Diego, California, U.S.A.
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    • M.W., R.T., and Q.N. are scientific advisors for Avelas Biosciences, a biotech company that has licensed the nerve probe technology described in this manuscript.

  • Jessica L. Crisp MS,

    1. Department of Chemistry and Biochemistry , UCSD, San Diego, California, U.S.A.
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  • Beth Friedman PhD,

    1. Department of Pharmacology , UCSD, San Diego, California, U.S.A.
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  • Roger Y. Tsien PhD,

    1. Howard Hughes Medical Institute, Departments of Pharmacology, Chemistry and Biochemistry , UCSD, San Diego, California, U.S.A.
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    • M.W., R.T., and Q.N. are scientific advisors for Avelas Biosciences, a biotech company that has licensed the nerve probe technology described in this manuscript.

  • Quyen T. Nguyen MD, PhD

    Corresponding author
    1. From the Division of Otolaryngology—Head and Neck Surgery, , UCSD, San Diego, California, U.S.A.
    • University of California–San Diego, 9500 Gilman Drive MC 0647, La Jolla, CA 92093-0647
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    • M.W., R.T., and Q.N. are scientific advisors for Avelas Biosciences, a biotech company that has licensed the nerve probe technology described in this manuscript.


  • This work was presented as an oral presentation at the Triological Society, COSM, Las Vegas, NV, on April 30, 2010.

  • This work was funded by the NIH Institutional Ruth L. Kirschstein-National Service Research Award (5 T32 DC000028-19) to A.W., NIH (NIBIB) K08 EB008122, and the Burroughs Wellcome Fund to Q.N.

Abstract

Objectives/Hypothesis:

By phage display, we have developed a novel peptide (NP41) that binds selectively to nerves following systemic administration. We evaluated the pattern of facial nerve labeling with fluorescently-labeled NP41 (F-NP41). We also tested whether F-NP41 highlights facial nerves well enough to identify nerve stumps accurately several weeks after nerve transection.

Study Design:

Forty-seven wild-type mice were studied prospectively. One surgeon performed the nerve transection, reanastomoses, and monitoring of functional recovery.

Methods:

Fluorescent labeling: F-NP41 was administered intravenously (20 mice). Nerve labeling was studied with fluorescence microscopy. Transection and reanastomosis: the right facial nerve was transected (25 mice). Three weeks after transection, F-NP41 was administered intravenously and fluorescence microscopy was used to identify the nerve stumps and reanastomosis in one group. Nerve identification and renastomosis was performed with white light in another group without F-NP41. The control group underwent sham surgery. Time to nerve identification was recorded. Functional recovery was monitored for at least 8 weeks.

Results:

We found excellent labeling of intact and transected facial nerves following F-NP41 administration. Several weeks following nerve transection, F-NP41 provided accurate identification of the proximal and distal nerve stumps. Following reanastomosis, time to recovery and level of functional recovery was similar in the absence and presence of F-NP41.

Conclusions:

We show improved visualization of facial nerves with a novel systemically applied fluorescently labeled probe. Use of F-NP41 resulted in accurate identification of facial nerve stumps several weeks following transection. Functional recovery was similar with and without the use of F-NP41. Laryngoscope, 2011

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