July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study
Author Affiliations & Notes
  • Alex D Blandford
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Waseem Ansari
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Thomas Plesec
    Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Catherine J Hwang
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Julian D Perry
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Alex Blandford, None; Waseem Ansari, None; Thomas Plesec, None; Catherine Hwang, None; Julian Perry, None
  • Footnotes
    Support  An Unrestricted Grant Awd from Research to Prevent Blindness to the Department of Ophthalmology, Cole Eye Institute (RPB1508DM) · Foundation Fighting Blindness Center Grant to the Cole Eye Institute (CCMM08120584CCF) · NEI/NIH P30 Core Center Grant (IP30EY025585)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5630. doi:
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    • Get Citation

      Alex D Blandford, Waseem Ansari, Thomas Plesec, Catherine J Hwang, Julian D Perry; Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5630.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : A first in class drug, deoxycholic acid (10mg/ml) was recently approved for reduction of submental fat. One of the rare but serious complications observed with its 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 (MMN).

Methods : A segment of MMN was harvested from twelve hemifaces of 6 fresh cadavers. The nerve specimen was exposed to either 0.9% sterile saline for 24 hours, deoxycholic acid (10mg/ml) for 20 minutes, or deoxycholic acid (10mg/ml) for 24 hours. Tissue fixed in glutaraldehyde for 24 then embedded in plastic and sectioned. Toluidine blue stained sections were qualitatively evaluated for stain intensity using light 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 hours showed less toluidine blue staining that that of the nerve exposed to dexoycholic acid for 20 minutes. Transmission electron microscopy of submental fat exposed to deoxycholic acid revealed disruption of adipocyte integrity and surrounding reticular meshwork when compared to specimens only exposed to saline.

Conclusions : Deoxycholic acid (10mg/ml) treated marginal mandibular nerve causes direct damage to the myelin sheath in fresh human cadaver specimens. Direct neurotoxic effect of deoxycholic acid may be responsible for marginal mandibular nerve injury in patients. Myelin damage seen in the marginal mandibular nerve should caution the use of deoxycholic acid in the periocular region.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

 

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