Murat Toraman1,2, Semra Külekçi Öztürk3, Berna Uslu Coşkun3,4, Pembegül Güneş5. 1. Department of Otorhinolaryngology/Head and Neck Surgery, Tunceli State Hospital, Tunceli-Elazığ Street, Tunceli Devlet Hastanesi, 2th Florr, Tunceli, 62000, Turkey. dr.murattoraman@gmail.com. 2. Department of Otorhinolaryngology/Head and Neck Surgery, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey. dr.murattoraman@gmail.com. 3. Department of Otorhinolaryngology/Head and Neck Surgery, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey. 4. Department of Otorhinolaryngology/Head and Neck Surgery, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey. 5. Department of Pathology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
Abstract
OBJECTIVE: 4-Aminopyridine (4-AP) is a potassium channel blocker that enhances nerve excitability. In this study, rat models that have facial nerve crush injury (FNCI) were grouped and treated with methylprednisolone (MP), 4-AP, and a combination of these two drugs. Electrophysiologic and histopathologic outcomes of these groups will be compared with a control group. MATERIALS AND METHODS: Thirty healthy male Wistar rats (mean weight of 265 g) were used in this study. The rats were randomly divided into five groups with six subjects in each: Group 1 (sham group), Group 2 (control group), Group 3 (MP group), Group 4 (4-aminopyridine group), and Group 5 (4-AP + MP group). All groups except the sham group underwent crush injury to the right facial nerve. Electrophysiologic and histologic recovery was recorded three weeks postoperatively. RESULTS: The 4-AP group and the combined group had a more significant recovery at Nerve Excitability Thresholds (NET) at the end of three weeks. The methylprednisolone group and the control group had a minimal recovery of NET. Histologically, when compared with the control group, the combined group was the only group that had significant recovery at all three of axonal degeneration, axon diameter, and myelin thickness. CONCLUSION: In this experimental study, we demonstrated that a combination treatment of 4-AP and MP is more effective in the recovery of peripheric FNCI than in the no-treatment control group and in the 4-AP- or MP-alone groups. Moreover, our results suggested that 4-AP can be a potent alternative to MP in the treatment of the FNCI. LEVEL OF EVIDENCE: N/A.
OBJECTIVE:4-Aminopyridine (4-AP) is a potassium channel blocker that enhances nerve excitability. In this study, rat models that have facial nerve crush injury (FNCI) were grouped and treated with methylprednisolone (MP), 4-AP, and a combination of these two drugs. Electrophysiologic and histopathologic outcomes of these groups will be compared with a control group. MATERIALS AND METHODS: Thirty healthy male Wistar rats (mean weight of 265 g) were used in this study. The rats were randomly divided into five groups with six subjects in each: Group 1 (sham group), Group 2 (control group), Group 3 (MP group), Group 4 (4-aminopyridine group), and Group 5 (4-AP + MP group). All groups except the sham group underwent crush injury to the right facial nerve. Electrophysiologic and histologic recovery was recorded three weeks postoperatively. RESULTS: The 4-AP group and the combined group had a more significant recovery at Nerve Excitability Thresholds (NET) at the end of three weeks. The methylprednisolone group and the control group had a minimal recovery of NET. Histologically, when compared with the control group, the combined group was the only group that had significant recovery at all three of axonal degeneration, axon diameter, and myelin thickness. CONCLUSION: In this experimental study, we demonstrated that a combination treatment of 4-AP and MP is more effective in the recovery of peripheric FNCI than in the no-treatment control group and in the 4-AP- or MP-alone groups. Moreover, our results suggested that 4-AP can be a potent alternative to MP in the treatment of the FNCI. LEVEL OF EVIDENCE: N/A.
Authors: Rahul Seth; Peter C Revenaugh; James A Kaltenbach; Karthik Rajasekaran; Noah E Meltzer; Debabrata Ghosh; Daniel S Alam Journal: Otolaryngol Head Neck Surg Date: 2012-07-17 Impact factor: 3.497
Authors: Prem Kumar Govindappa; Mashanipalya G Jagadeeshaprasad; Peter Tortora; M A Hassan Talukder; John C Elfar Journal: J Hand Surg Am Date: 2022-04-10 Impact factor: 2.342