Nimodipine promotes regeneration of peripheral facial nerve function after traumatic injury following maxillofacial surgery: An off label pilot-study

Scheller, Konstanze; Scheller, Christian

doi:10.1016/j.jcms.2011.07.016

Cited by 40 publications

(39 citation statements)

References 25 publications

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“…2,20,21,24,25 Furthermore, these positive results were also observed in laryngeal 8,14 and maxillofacial surgery 23 and may therefore be transferable to other surgical procedures with nerves at risk.…”

Section: Generalizabilitymentioning

confidence: 79%

“…Although Voluven 6% is approved by the FDA and no adverse events related to HES (especially renal toxicity) were observed in the present study, the neuroprotective effect of HES is questionable, taking into consideration that animal experiments and clinical trials using nimodipine alone showed evidence of comparable neuroprotective efficacy. 1,6,8,9,[12][13][14][15]23 From a pharmacokinetic point of view, parenteral ni- modipine produces higher drug levels and has a higher neuroprotective efficacy compared with enteral administration. 22 Therefore, a central venous access is needed.…”

Section: Study Medicationmentioning

confidence: 99%

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Prophylactic nimodipine treatment for cochlear and facial nerve preservation after vestibular schwannoma surgery: a randomized multicenter Phase III trial

Scheller¹,

Wienke

Tatagiba

et al. 2016

JNS

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obJective A pilot study of prophylactic nimodipine and hydroxyethyl starch treatment showed a beneficial effect on facial and cochlear nerve preservation following vestibular schwannoma (VS) surgery. A prospective Phase III trial was undertaken to confirm these results. methods An open-label, 2-arm, randomized parallel group and multicenter Phase III trial with blinded expert review was performed and included 112 patients who underwent VS surgery between January 2010 and February 2013 at 7 departments of neurosurgery to investigate the efficacy and safety of the prophylaxis. The surgery was performed after the patients were randomly assigned to one of 2 groups using online randomization. The treatment group (n = 56) received parenteral nimodipine (1-2 mg/hr) and hydroxyethyl starch (hematocrit 30%-35%) from the day before surgery until the 7th postoperative day. The control group (n = 56) was not treated prophylactically. results Intent-to-treat analysis showed no statistically significant effects of the treatment on either preservation of facial nerve function (35 [ ]) (p = 0.530) 12 months after surgery. Since tumor sizes were significantly larger in the treatment group than in the control group, logistic regression analysis was required. The risk for deterioration of facial nerve function was adjusted nearly the same in both groups ], p = 0.91). In contrast, the risk for postoperative hearing loss was adjusted 2 times lower in the treatment group compared with the control group (OR 0.49 [95% CI 0.18-1.30], p = 0.15). Apart from dosedependent hypotension (p < 0.001), no clinically relevant adverse reactions were observed. coNclusioNs There were no statistically significant effects of the treatment. Despite the width of the confidence intervals, the odds ratios may suggest but do not prove a clinically relevant effect of the safe study medication on the preservation of cochlear nerve function after VS surgery. Further study is needed before prophylactic nimodipine can be recommended in VS surgery.Clinical trial registration no.: 2009-012088-32 (www.clinicaltrialsregister.eu)

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Section: Generalizabilitymentioning

confidence: 79%

Section: Study Medicationmentioning

confidence: 99%

Prophylactic nimodipine treatment for cochlear and facial nerve preservation after vestibular schwannoma surgery: a randomized multicenter Phase III trial

Scheller¹,

Wienke

Tatagiba

et al. 2016

JNS

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“…Its neuroprotective effect has been shown in several clinical trials [2,8,14] and animal experiments [4,5]. Nimodipine binds to the α1 subunit of the L-type calcium channel [15] and is rapidly and widely distributed in cerebral tissue [16].…”

Section: Discussionmentioning

confidence: 99%

“…It is recommended for the management of aneurysmal subarachnoid hemorrhage (aSAH) and has a proven effect in reducing poor outcome and delayed ischemic neurological deficits (DIND) following aSAH [2,3]. Additionally, its beneficial effect in skull base, laryngeal and maxillofacial surgery has been demonstrated in several animal experiments [4,5] and clinical series [6,7,8]. These positive results have been attributed to neuroprotection [9].…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Neuroprotective Impact of Nimodipine on Neuro2a Cells by Means of a Surgery-Like Stress Model

Herzfeld

Strauß

Simmermacher

et al. 2014

IJMS

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Nimodipine is well characterized for the management of SAH (subarachnoid hemorrhage) and has been shown to promote a better outcome and less DIND (delayed ischemic neurological deficits). In rat experiments, enhanced axonal sprouting and higher survival of motoneurons was demonstrated after cutting or crushing the facial nerve by nimodipine. These results were confirmed in clinical trials following vestibular Schwannoma surgery. The mechanism of the protective competence of nimodipine is unknown. Therefore, in this study, we established an in vitro model to examine the survival of Neuro2a cells after different stress stimuli occurring during surgery with or without nimodipine. Nimodipine significantly decreased ethanol-induced cell death of cells up to approximately 9% in all tested concentrations. Heat-induced cell death was diminished by approximately 2.5% by nimodipine. Cell death induced by mechanical treatment was reduced up to 15% by nimodipine. Our findings indicate that nimodipine rescues Neuro2a cells faintly, but significantly, from ethanol-, heat- and mechanically-induced cell death to different extents in a dosage-dependent manner. This model seems suitable for further investigation of the molecular mechanisms involved in the neuroprotective signal pathways influenced by nimodipine.

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“…Nowadays, facial paralysis continues as critical issue in clinical regardless of developed and sophisticated medical [3] and physical therapy interventions. A great numbers of measurement scales of facial nerve function have been proposed in the literature over the years.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Objective Assessment of Facial Paralysis with House-Brackmann Score

Samsudin¹,

Samad²,

Sundaraj³

et al. 2017

TELKOMNIKA

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Nimodipine promotes regeneration of peripheral facial nerve function after traumatic injury following maxillofacial surgery: An off label pilot-study

Cited by 40 publications

References 25 publications

Prophylactic nimodipine treatment for cochlear and facial nerve preservation after vestibular schwannoma surgery: a randomized multicenter Phase III trial

Prophylactic nimodipine treatment for cochlear and facial nerve preservation after vestibular schwannoma surgery: a randomized multicenter Phase III trial

Investigation of the Neuroprotective Impact of Nimodipine on Neuro2a Cells by Means of a Surgery-Like Stress Model

Correlation of Objective Assessment of Facial Paralysis with House-Brackmann Score

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