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

Abstract

BACKGROUND:

Animal tests, retro- and prospective clinical trials in neurosurgical departments have shown a beneficial effect of nimodipine on the preservation and recovery of facial and acoustic nerve function following vestibular schwannoma surgery. Encouraged by these positive results a pilot-study of nimodipine treatment in patients with a peripheral facial nerve (FN) paresis following maxillofacial surgery was performed. The rate and time of FN recovery were analysed and compared with the results in the literature.

METHODS:

Thirteen patients (n = 13) suffering from a moderate (1/13) up to a severe (12/13) peripheral FN paresis after maxillofacial surgery were treated with orally administered nimodipine. The anatomical main course of the FN was preserved in all patients with a 2nd to 3rd degree of Sunderland-injury (Sunderland, 1951). After no evidence of a spontaneous regeneration had shown, oral medication with nimodipine was started as an "off-label" use.

RESULTS:

An improvement of the FN function correlated to the start of the vasoactive medication and as a consequence a recovery of the FN function up to House-Brackmann (HB) grade I°-II° was observed in all the patients within a period of 2 months after the beginning of treatment (p = 0.00027).

CONCLUSIONS:

The clinical observations in these patients suggest a positive effect of nimodipine on the acceleration of peripheral FN regeneration after surgically caused trauma. The results of this pilot-study are very promising. A prospective study with a larger number of patients is planned to approve the beneficial effect of nimodipine on the peripheral FN in maxillofacial or otorhinolaryngological surgery.

• Authors: K Scheller, C Scheller
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 40 Issue 5 Pg. 427-34 (Jul 2012) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 21885293 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Vasodilator Agents
• Nimodipine

Topics

• Adolescent
• Adult
• Aged
• Facial Bones (injuries)
• Facial Nerve (drug effects)
• Facial Nerve Injuries (drug therapy, etiology)
• Facial Paralysis (drug therapy, etiology)
• Female
• Follow-Up Studies
• Humans
• Male
• Mandibular Condyle (injuries)
• Mandibular Fractures (surgery)
• Middle Aged
• Muscle Weakness (drug therapy)
• Nerve Regeneration (drug effects)
• Nimodipine (therapeutic use)
• Off-Label Use
• Oral Surgical Procedures (adverse effects)
• Osteotomy, Sagittal Split Ramus (adverse effects)
• Parotid Diseases (surgery)
• Parotid Neoplasms (surgery)
• Pilot Projects
• Postoperative Complications
• Prognathism (surgery)
• Recovery of Function (drug effects)
• Skull Fractures (surgery)
• Vasodilator Agents (therapeutic use)
• Young Adult