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The effects of 4-aminopyridine and methylprednisolone on recovery of the facial nerve crush injury

  • Head and Neck
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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.

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Funding

Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology/Head and Neck Surgery, Tunceli State Hospital, Tunceli-Elazığ Street, Tunceli Devlet Hastanesi, 2th Florr, Tunceli, 62000, Turkey

    Murat Toraman

  2. Department of Otorhinolaryngology/Head and Neck Surgery, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey

    Murat Toraman, Semra Külekçi Öztürk & Berna Uslu Coşkun

  3. Department of Otorhinolaryngology/Head and Neck Surgery, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey

    Berna Uslu Coşkun

  4. Department of Pathology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey

    Pembegül Güneş

Authors
  1. Murat Toraman
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  2. Semra Külekçi Öztürk
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  4. Pembegül Güneş
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Correspondence to Murat Toraman.

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This study was approved by the Marmara University Local Ethics Committee for Animal Experiments and performed at the Marmara University School of Medicine, Experimental Animal Laboratory, Istanbul, Turkey.

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Toraman, M., Külekçi Öztürk, S., Uslu Coşkun, B. et al. The effects of 4-aminopyridine and methylprednisolone on recovery of the facial nerve crush injury. Eur Arch Otorhinolaryngol 278, 3057–3063 (2021). https://doi.org/10.1007/s00405-020-06483-w

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  • DOI: https://doi.org/10.1007/s00405-020-06483-w

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