Efficasy of nimodipine and methylprednisolone on healing in travmatic facial nerve crush

ABSTRACTEFFICASY OF NIMODIPINE AND METHYLPREDNISOLONE ON HEALING IN TRAVMATIC FACIAL NERVE CRUSHThis study aims to investigate the effectiveness of methylprednisolone and nimodipine in facial nerve paralysis models induced by facial nerve compression.The study was conducted on 28 female New Zealand rabbits weighing between 1200-3000 gr. The buccal branches of the facial nerves of rabbits were compressed and performed a facial nerve paralysis. The rabbits were randomly divided into four groups, seven rabbits in each. In Group 1 (Nimodipine Group) intraperitoneal 0.5 mg/kg/day dose of nimodipine, in Group 2 (Methylprednisolone Group) intramuscular 1 mg/kg/day, in Group 3 (Nimodipine and Methylprednisolone Group) intraperitoneal 0.5 mg/kg/day nimodipine and 1 mg/kg/day intramuscular methylprednisolon, in Group 4 (The Control Group) intramuscular 1 cc saline were given for three weeks. Then, the buccal branches of the facial nerves of rabbits were removed from the side where paralysis was performed. Semithin sections from the specimen were analyzed for perineural fibrosis, rate of increase in collagen fibers, miyelin degeneration, axonal degeneration, Schwann cell proliferation, normal miyelin structure and edema by using an optical microscope. Four areas were analyzed (on an objective magnification of 40X, 100X, 200X, and 1000X) in four sections taken from each group. The mean values of the data pertaining to these areas were calculated, and the results were classified into four categories: Absent: - (0), mild: + (1), moderate: ++ (2), and severe: +++ (3).In this experimental study, no significant difference was identified between the nimodipine group and the control group in perineural fibrosis, Schwann cell proliferation and edema but a significant difference was identified in rate of increase in collagen fibers, miyelin degeneration, axonal degeneration, normal miyelin structure (p<0.05). A significant difference was observed between nimodipine group and methylprednisolone group and between nimodipine group and nimodipine-methylprednisolone in edema (p<0.05) but there was no significant difference was observed in other parameters. There was no significant difference between methylprednisolone group and control group in perineural fibrosis, Schwann cell proliferation and normal miyelin structure but there was a significant difference in rate of increase in collagen fibers, miyelin degeneration, axonal degeneration and edema (p<0.05). There was no significant difference between methylprednisolone group and nimodipine-methylprednisolone group in any parameters (p>0.05). There was no significant difference between nimodipine-methylprednisolone group and control group in perineural fibrosis, Schwann cell proliferation but there was a significant difference in rate of increase in collagen fibers, miyelin degeneration, axonal degeneration, normal miyelin structure and edema (p<0.05).At the result of our study we can say that, in the travmatic facial nerve paralysis where integrity protected, nimodipine and methylprednisolone has a positive effect in nerve recovery but there was no significant diffence between two of them.Keywords: Facial nerve paralysis, Nimodipine, Methylprednisolone.