Allograft nerve repair to prevent sensorimotor loss after nerve sheath tumor resection

Neurosurg Focus Video. 2023 Jan 1;8(1):V16. doi: 10.3171/2022.10.FOCVID22101. eCollection 2023 Jan.

Abstract

Acellularized nerve allografts (ANAs) have been developed as substitutes for nerve autograft to promote nerve regeneration after surgical repair. In this video, the authors demonstrate operative techniques for using ANAs to repair potentially functional nerve fascicles during tumor resection. A 67-year-old female with schwannomatosis requested resection of a painful enlarging mass of the left ulnar nerve proximal to the elbow. During surgery, neuromonitoring suggested that fascicles entering the tumor could be functional. Therefore, nerve allograft was used to repair the transected fascicles. The patient recovered with full strength and sensation in the ulnar distribution, with resolution of her preoperative symptoms. The video can be found here: https://stream.cadmore.media/r10.3171/2022.10.FOCVID22101.

Keywords: nerve allograft; nerve repair; nerve sheath tumor; schwannoma.