Nimodipine improves vocal fold and facial motion recovery after injury: A systematic review and meta‐analysis

Abstract

Introduction Nimodipine is a calcium channel blocker that has been used to treat hypertension and vasospasm. Emerging evidence in the literature suggests that it is neuroprotective by reducing cellular apoptosis after neuronal injury and promoting axonal sprouting at the nodes of Ranvier. Objectives To conduct a systematic review of the usage of nimodipine in cranial nerve injury and to perform a meta‐analysis to estimate the efficacy of nimodipine on functional recovery of the injured cranial nerves. Methods Literature search was performed in eight databases using preferred reporting items for systematic reviews and meta analyses (PRISMA) guidelines. Human studies that used nimodipine as a monotherapy for treating cranial nerve injury were included for review. Cranial nerve function recovery was the primary outcome measure. Results 672 records were screened and 58 full texts in English were assessed. Nine studies were included in the final review. 5 of these, including 110 participants who received nimodipine for either recurrent laryngeal nerve or facial nerve injury and 556 controls, were used for meta‐analysis. Nimodipine significantly increased the odds of vocal fold motion recovery (odds ratio [OR] 13.73, 95% confidence interval [CI] 6.21, 30.38, P < .01), and the odds of facial motion recovery (OR 2.78, 95% CI 1.20, 6.44, P = .02). Overall, nimodipine‐treated patients had significantly higher odds of recovering vocal fold or facial motion compared with controls (OR 6.09, 95% CI 3.41, 10.87, P < .01). Conclusion Existing evidence supports the positive effect of nimodipine on vocal fold and facial motion recovery after injury. Future research should focus on randomized clinical trials comparing recovery rates between nimodipine‐ and placebo‐treated groups. Laryngoscope, 129:943–951, 2019

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

“…Nimodipine is a calcium channel blocker which has a neuroprotective effect via the decrease of cellular apoptosis after neuronal injury, and also promotes axonal sprouting at the nodes of Ranvier. 20 A recent meta-analysis published in 2019 demonstrated that it significantly increased the likelihood of facial motion recovery. 20 However, high-quality evidence justifying the use of nimodipine is still lacking.…”

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

“…Patients with unilateral VFP who undergo early injection laryngoplasty are less likely to require long‐term medialization procedures in the form of thyroplasty than those who did not receive early injection laryngoplasty 40 . Investigations of treatments, like nimodipine in the acute period of VFP, are promising but requires further evaluation before being widely adopted 41,42 . The early involvement of an Otolaryngologist‐Head and Neck Surgeon and Speech Language Pathologist is key in the decision‐making process for early intervention.…”

“…40 Investigations of treatments, like nimodipine in the acute period of VFP, are promising but requires further evaluation before being widely adopted. 41,42 The early involvement of an Otolaryngologist-Head and Neck Surgeon and Speech Language Pathologist is key in the decision-making process for early intervention.…”

Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study

“…Nimodipine is a second-generation dihydrotestosterone pyridine class calcium antagonist, and nimodipine has high lipophilicity, which makes it rapidly cross the blood-brain barrier. The main mechanism of nimodipine is selective blockade of intracellular calcium ow through L-type calcium channels [10]. Nimodipine is considered the rst choice for the prevention of CVS after SAH and has been approved in the United States [11], Canada [12] and other countries [13].…”