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Published in:

01-10-2018 | Original Article

Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study

Authors: Alexander D. Blandford, Waseem Ansari, Jason M. Young, Bruce Maley, Thomas P. Plesec, Catherine J. Hwang, Julian D. Perry

Published in: Aesthetic Plastic Surgery | Issue 5/2018

Abstract

Background

One of the rare but serious complications observed with deoxycholic acid administration is damage to the marginal mandibular nerve. In this study, we evaluated if deoxycholic acid directly induces histologic damage to fresh cadaveric marginal mandibular nerve.

Methods

A segment of marginal mandibular nerve was harvested from 12 hemifaces of 6 fresh cadavers. The nerve specimen was exposed to either 0.9% sterile saline for 24 h, deoxycholic acid (10 mg/ml) for 20 min, or deoxycholic acid (10 mg/ml) for 24 h. The nerve specimens were then fixed in glutaraldehyde for a minimum of 24 h. Toluidine blue stained sections were evaluated for stain intensity using light microscopy and color deconvolution image analysis. Supraplatysmal fat was harvested as a positive control and exposed to the same treatments as the marginal mandibular nerve specimens, then evaluated using transmission electron microscopy.

Results

Toluidine blue staining was less in the marginal mandibular nerve exposed to deoxycholic acid when compared to saline. The specimen exposed to deoxycholic acid for 24 h showed less toluidine blue staining than that of the nerve exposed to deoxycholic acid for 20 min. Transmission electron microscopy of submental fat exposed to deoxycholic acid revealed disruption of adipocyte cell membrane integrity and loss of cellular organelles when compared to specimens only exposed to saline.

Conclusions

Deoxycholic acid (10 mg/ml) damages the marginal mandibular nerve myelin sheath in fresh human cadaver specimens. Direct deoxycholic acid neurotoxicity may cause marginal mandibular nerve injury clinically.

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ASDS survey: seven out of ten consumers considering cosmetic procedures. https://www.asds.net/2017-consumer-survey/. Accessed 27 Jan 2018

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Title: Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study
Authors: Alexander D. Blandford
Waseem Ansari
Jason M. Young
Bruce Maley
Thomas P. Plesec
Catherine J. Hwang
Julian D. Perry
Publication date: 01-10-2018
Publisher: Springer US
Published in: Aesthetic Plastic Surgery / Issue 5/2018
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI: https://doi.org/10.1007/s00266-018-1164-4

At a glance: The STEP trials

Springer Medicine

Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study

Abstract

Background

Methods

Results

Conclusions

No Level Assigned

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

No Level Assigned

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