American Society for Peripheral Nerve (ASPN)
Spring 2021 Issue
Oh, what a meeting!

Huge congratulations to Program Chair, Kristen Davidge, and President, Greg Borschel, on a phenomenal Nerve Week! (PRRI was on-point as well)! The first virtual ASPN annual meeting did not disappoint! There were abstract presentations, lively panel discussions, the not-to-be-missed poster session, and social networking fun. The theme, to escort 2020 out, was PAIN, and there was a giant nod to Hawaiian dreaming! Congratulations to all of the presenters and panelists on a job well-done! If you missed any riveting moment, registrants can access the on-demand programming on the ASPN website at meeting.peripheralnerve.org. Congratulations to Steve Kemp on his spectacular Hawaiian shirt, which won him free registration for the 2022 annual meeting in Carlsbad, California. We cannot wait to see everyone there!!!


Petros Konofaos, M.D., Ph.D
Direct Muscle Neurotization: A concept pioneered by Dr Giorgio Brunelli
Direct muscle neurotization (DMN) is indicated when reinnervation by direct nerve repair or with the use of nerve graft is not possible because of the lack of a distal nerve segment. DMN was introduced by von Hacker [1] in 1908 who reported a successful direct neurotization of the trapezius muscle by implanting part of the accessory nerve in the muscle belly in an 11-year-old female patient

In 1915, Steindler [2] and Erlacher [3] in 1915 independently reported successful direct muscle neurotization of denervated muscles using animal models. Aitken [4], in 1950, proposed a method of implanting nerves in muscle with minimal injury to the muscle and suggested that the implanted nerve formed functioning motor end plates in more than one location around the implantation site. In 1972, Sakelarides et al [5], using a dog model of DMN, reported 60 to 75 % of functional recovery by dividing the implanted nerve into several fascicles. Moreover, the macroscopic appearance of the directly innervated muscles was similar to normal muscles.
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Peripheral nerve injuries are a public health issue in Mexico. Every year thousands of individuals show nerve injuries on either the extremities or the facial region, resulting in disability, loss of income, and decreased quality of life. Consequently, local training of peripheral nerve surgeons is becoming an ever-increasing need in our community.
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In Germany, nerve surgery is performed by plastic surgeons, neurosurgeons and, in some instances, orthopedic/trauma surgeons. There are no formal fellowships after residency. Rather, the novice residency graduate begins working with a specialist in a certain subspecialty and thus acquires subspecialty skills.
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Welcome new recruits!!!!

Learn about some of the newest members of ASPN:
Drs. Nikhil Agrawal, Geetanjali Bendale, and Manas Nigam!


Nikhil Agrawal, MD

Dr. Nikhil Agrawal graduated from Washington University in St. Louis then returned home for medical school at the Ohio State University. He completed Plastic Surgery residency at Baylor College of Medicine with nerve surgeons Dr. Michael Klebuc and Dr. Chris Pederson. He is now finishing Hand and Peripheral Nerve Fellowship at Massachusetts General Hospital with Dr. Ian Valerio, Dr. Kyle Ebelin, and Dr. Jonathan Winograd. Dr. Agrawal is joining the Long Island Plastic Surgery Group in September 2021.
 
Geetanjali Bendale, PhD
Research Scientist
VCU Department of Orthopaedic Surgery

Geetanjali Bendale received her doctoral degree in Bioengineering from the University of Texas at Dallas in May 2019. She joined Virginia Commonwealth University as a Research Scientist (Assistant Professor) in September 2019 within the Hand Surgery department. With a background in peripheral nerve regeneration and medical devices, her main areas of research are improving nerve repair techniques, enhance axon regeneration, treatments for muscle atrophy and increase functional outcomes.
 
Manas Nigam, MD
Academic Chief Resident
Department of Plastic and Reconstructive Surgery
MedStar Georgetown University Hospital

Manas Nigam, MD, looks forward to working with colleagues all around the world through ASPN, whether it be collaborative research endeavors or friendly academic debate in the spirit of innovation. He is currently Administrative Chief Resident of Plastic and Reconstructive Surgery at Georgetown University Hospital in Washington, D.C. Next year, he will be completing a Hand and Upper Extremity Fellowship at Baylor College of Medicine. He is interested in Targeted Muscle Reinnervation, Osseo-integrated Devices, and Pain Management.


Did you know? by Dr. Joe Catapano

Joseph Catapano, MD
The difference in the regenerative potential of the peripheral and central nervous system is well established, as is the important role that Schwann cells play in regulating peripheral nerve regeneration. Our colleagues in other specialties are taking advantage of this, investigating how peripheral nerve-derived Schwann cells can be used as a means of delivery of neurotrophic factors to the central nervous system. Who knows where this research will lead, but it could provide exciting new avenues for the application of peripheral nerve surgery or expand our knowledge of how to maximize the regenerative potential of the peripheral nervous system. Read more in the following references from a group implanting peripheral nerve grafts into the substantia nigra in patients with Parkinson’s Disease as a source of neuropathic factors to restore function:

van Horne et al. (2018) Peripheral nerve grafts implanted into the substantia nigra in patients with Parkinson's disease during deep brain stiulation surgery - 1-year follow-up study of safety, feasibility, and clinical outcome

Seblani et al. (2020) Utilizing peripheral nerve regenerative elements to repair damage in the CN


Aron Wahrman, MD, MBA
(Occasional notes from an unapologetic bibliophile and indulged husband)
Pierre Huard (1901-83) Surgeon, Soldier, Historian and Anthropologist
After 28 years, my repeat viewing of “Indochine”, the 1993 winner of the Academy Award for Best Foreign Film, was still a highly evocative and visually engrossing look at Vietnam under French rule. Catherine Deneuve plays Eliane, the wealthy French heiress to a huge rubber plantation near Saigon; she adopts the young child Camille, the orphaned daughter of Vietnamese friends. A series of historic events and human dramas become allegoric mirrors of the changing relationship and turmoil between the colonized and the colonizers. The plot begins in the 1930s ultimately ending at the 1954 Geneva Convention, when Vietnam not only cast off French rule during the First Indochina War, but was sadly sundered into the Communist Democratic State in the North and the State of Vietnam to the South. More open American involvement would come later. Seventy years hence, that era and its subsequent history continues to be written; as a VA surgeon I see the human toll of our previous involvement in Indochina almost every day.
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Upcoming meetings around the globe

Plastic Surgery Research Council (PSRC): Virtual! June 7-11, 2021 ps-rc.org/meeting
American Association of Plastic Surgeons (AAPS): May 15-18, 2021 in Miami, FL meeting.aaps1921.org


Penny for your thoughts?

Thank you to everyone who responded to the “Penny for your thoughts” in issue 7. Results are depicted in the graphs below:

  1. Have you traveled outside of your country for formal or informal education related to nerve surgery?
  2. If willing to share centers and locations to which you have traveled for nerve-related education, please list them here:
    • Chang Gung Memorial Hospital, Taiwan
    • Khoo Texk Puat Hospital, Singapore
  3. Where was your first international conference?
    • Chicago, USA
    • Vienna, Austria

Now for the next figurative penny...

  1. Do you have social media accounts?
  2. If so, which social media platforms do you use?
    1. Twitter
    2. FaceBook
    3. Instagram
    4. YouTube
    5. TikTok
    6. SnapChat
  3. If you use social media, how often?
Respond Here

ASPN is now on Instagram! Follow the Society at @nervenerds! If you would like to get involved with the ASPN Social Media Committee, volunteer here!


Introducing our newest column to highlight the creative expressions of our membership...
Please send us your non-clinical artistic endeavors—visual, text, audio… anything! Nerve not necessary here—we want to highlight our very talented members!
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A brief interview with ASPN Mentorship Committee Chair Dr. Jonathan Winograd (Attending Surgeon at Massachusetts General Hospital) and ASPN Mentorship Program mentee Dr. Kevin Zuo (Resident at University of Toronto). The full interview video can be viewed here: https://youtu.be/aldXC0G_QjM

The ASPN Mentorship Program pairs established members of the peripheral nerve community with young faculty, fellows, and residents to provide them with the unique opportunity to gain experience from seasoned experts in the field.
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Show me the money... research money!

Do you have great ideas? Do you love science? Well, then get your projects funded!!! Translate your ideas to projects! Create data to help us all! The ASPN Grants Committee has compiled valuable information to help fund your nerve-related science... follow the link to learn more! #scienceiscool

See the ASPN list of peripheral nerve funding sources!


I know you!

Here they are... your fearless 2021 ASPN Executive Council