Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons?
Peripheral nerve injuries remain a challenge for reconstructive surgeons with many patients obtaining suboptimal results. Understanding the level of injury is imperative for successful repair. Current methods for distinguishing healthy from damaged nerve are time consuming and possess limited effica...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2015-09-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.5.626 |
| _version_ | 1798037694357438464 |
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| author | Christopher S Crowe Joseph C Liao Catherine M Curtin |
| author_facet | Christopher S Crowe Joseph C Liao Catherine M Curtin |
| author_sort | Christopher S Crowe |
| collection | DOAJ |
| description | Peripheral nerve injuries remain a challenge for reconstructive surgeons with many patients obtaining suboptimal results. Understanding the level of injury is imperative for successful repair. Current methods for distinguishing healthy from damaged nerve are time consuming and possess limited efficacy. Confocal laser endomicroscopy (CLE) is an emerging optical biopsy technology that enables dynamic, high resolution, sub-surface imaging of live tissue. Porcine sciatic nerve was either left undamaged or briefly clamped to simulate injury. Diluted fluorescein was applied topically to the nerve. CLE imaging was performed by direct contact of the probe with nerve tissue. Images representative of both damaged and undamaged nerve fibers were collected and compared to routine H&E histology. Optical biopsy of undamaged nerve revealed bands of longitudinal nerve fibers, distinct from surrounding adipose and connective tissue. When damaged, these bands appear truncated and terminate in blebs of opacity. H&E staining revealed similar features in damaged nerve fibers. These results prompt development of a protocol for imaging peripheral nerves intraoperatively. To this end, improving surgeons' ability to understand the level of injury through real-time imaging will allow for faster and more informed operative decisions than the current standard permits. |
| first_indexed | 2024-04-11T21:30:02Z |
| format | Article |
| id | doaj.art-1415cacc9718440eb3a4126883c88375 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-11T21:30:02Z |
| publishDate | 2015-09-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-1415cacc9718440eb3a4126883c883752022-12-22T04:02:01ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712015-09-01420562662910.5999/aps.2015.42.5.626572Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons?Christopher S Crowe0Joseph C Liao1Catherine M Curtin21Division of Plastic and Reconstructive Surgery, Stanford School of Medicine, Stanford, CA, USA2Division of Urology, Stanford School of Medicine, Stanford, CA, USA1Division of Plastic and Reconstructive Surgery, Stanford School of Medicine, Stanford, CA, USAPeripheral nerve injuries remain a challenge for reconstructive surgeons with many patients obtaining suboptimal results. Understanding the level of injury is imperative for successful repair. Current methods for distinguishing healthy from damaged nerve are time consuming and possess limited efficacy. Confocal laser endomicroscopy (CLE) is an emerging optical biopsy technology that enables dynamic, high resolution, sub-surface imaging of live tissue. Porcine sciatic nerve was either left undamaged or briefly clamped to simulate injury. Diluted fluorescein was applied topically to the nerve. CLE imaging was performed by direct contact of the probe with nerve tissue. Images representative of both damaged and undamaged nerve fibers were collected and compared to routine H&E histology. Optical biopsy of undamaged nerve revealed bands of longitudinal nerve fibers, distinct from surrounding adipose and connective tissue. When damaged, these bands appear truncated and terminate in blebs of opacity. H&E staining revealed similar features in damaged nerve fibers. These results prompt development of a protocol for imaging peripheral nerves intraoperatively. To this end, improving surgeons' ability to understand the level of injury through real-time imaging will allow for faster and more informed operative decisions than the current standard permits.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.5.626trauma, nervous systemmicroscopybiopsydiagnostic imaginghistological techniques |
| spellingShingle | Christopher S Crowe Joseph C Liao Catherine M Curtin Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? Archives of Plastic Surgery trauma, nervous system microscopy biopsy diagnostic imaging histological techniques |
| title | Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? |
| title_full | Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? |
| title_fullStr | Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? |
| title_full_unstemmed | Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? |
| title_short | Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons? |
| title_sort | optical biopsy of peripheral nerve using confocal laser endomicroscopy a new tool for nerve surgeons |
| topic | trauma, nervous system microscopy biopsy diagnostic imaging histological techniques |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2015.42.5.626 |
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