Human Nerve Material Repairs Facial Nerve Damage

A new allograft nerve graft can now be used to treat lost sensation and repair lingual and inferior alveolar nerve following traumatic oral surgery.

The Avance Nerve Graft is a human allograft nerve used for the repair, replacement, and reconstruction of damaged peripheral nerves, and is available as an option for secondary neurorrhaphy surgery when nerve damage is too extensive for a primary neurorrhaphy procedure. Avance is pliable and handles similar to an autograft nerve. It is supplied sterile in a variety of lengths and diameters, and is implanted using microsurgical techniques, similar to an autograft, but without the risks associated with autograft nerve transplant, including the need for a second surgical procedure to remove nerve tissue. The graft is supplied frozen, and needs to be thawed to room temperature in a sterile Ringer solution before implantation.

Recovery of the nerve tissue from the donor is done using aseptic techniques, and only after donor eligibility is carefully evaluated for high-risk behaviors and relevant communicable diseases. Screening includes a review of the donor medical and social history, physical assessment of the donor, review of an autopsy (if performed), review of relevant medical records including cause of death, serology testing, and tissue recovery microbiology. The graft is then minimally processed to preserve the three-dimensional (3D) structure of the nerve and the inherent neurotropic support, laminin. This process clears the cellular and noncellular material from the tissue, including cells, cellular debris, axons, as well as chondroitin sulfate proteoglycans (CSPG), a naturally occurring inhibitor to axon regeneration. The resulting nerve graft provides a sterile scaffold to allow the natural healing process to regenerate peripheral nerves. The Avance Nerve Graft is a product of AxoGen (Alachua, FL, USA), and has been approved by the U.S. Food and Drug Administration (FDA).

Lingual and inferior alveolar nerve damage affects some patients treated with certain oral surgery procedures including tooth extraction or root canal treatment. In many cases, patients regain sensation without surgery or other treatment. But for some patients, the loss of nerve function will be permanent without surgical intervention.

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