1
|
Tian M, Ma X, Lu Q, Xue G, Li L, Wu A, Zang H, Nie L. Study on the mechanism of ischemic stroke treatment based on network pharmacology and Raman spectroscopy in the larval zebrafish model, Calculus Bovis as a case. Int Immunopharmacol 2024; 141:112914. [PMID: 39181017 DOI: 10.1016/j.intimp.2024.112914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/31/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024]
Abstract
Calculus Bovis (C. bovis) is a precious traditional Chinese medicine of animal origin, and it is one of the traditional medicines for treating cerebral inflammatory diseases such as stroke. However, the pharmacological action of C. bovis on ischemic stroke (IS) and its mechanism are still unclear. The purpose of this study was to investigate the potential mechanism to treat IS. Chemical constituents of different varieties of C. bovis were analyzed and confirmed by HPLC-MS/MS technique. We constructed a component and corresponding target network and drug-disease target protein-protein interaction (PPI) network. GO and KEGG enrichment analysis were performed. The molecular docking of the main compound with the target protein. Subsequently, the potential mechanism of therapy for IS was verified in vivo by zebrafish model. We introduced Raman spectroscopy to detect changes in the biochemical composition of zebrafish. 13 active chemical constituents and 129 potential targets were selected. 122 KEGG signaling pathways were obtained. The binding energy of the main compounds is less than -4.5. The results of animal experiments showed that C. bovis could significantly improve Ponatinib-induced IS, decrease the aggregation degree of brain macrophages, reduce the number of macrophage migrations, and significantly increase the expression level of NR3C1. Raman information indicated that the biochemical composition in the brain of the Ponatinib-induced group shifted to the control group. The mechanism may be related to anti-inflammatory process and regulation of lipid metabolism. This study demonstrates that Raman spectroscopy has great potential as a drug evaluation tool in living larval zebrafish.
Collapse
Affiliation(s)
- Mengyin Tian
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Xiaobo Ma
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Qingqing Lu
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Gao Xue
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Lian Li
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Aoli Wu
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| | - Hengchang Zang
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China.
| | - Lei Nie
- NMPA Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Key Laboratory of Chemical Biology (Ministry of Education), Shandong University, Jinan, Shandong 250012, China; National Glycoengineering Research Center, Shandong University, Jinan, Shandong 250012, China
| |
Collapse
|
2
|
Yancey KL, Patro A, Smetak M, Perkins EL, Isaacson B, Bennett ML, O'Malley M, Haynes DS, Hunter JB. Evaluating calcium channel blockers and bisphosphonates as otoprotective agents in cochlear implantation hearing preservation candidates. Cochlear Implants Int 2024:1-9. [PMID: 38738388 DOI: 10.1080/14670100.2024.2338003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVES Evaluate potential effects of calcium channel blockers (CCB) and bisphosphonates (BP) on residual hearing following cochlear implantation. METHODS Medications of 303 adult hearing preservation (HP) candidates (low frequency pure tone average [LFPTA] of 125, 250, and 500 Hz ≤80 dB HL) were reviewed. Postimplantation LFPTA of patients taking CCBs and BPs were compared to controls matched by age and preimplantation LFPTA. RESULTS Twenty-six HP candidates were taking a CCB (N = 14) or bisphosphonate (N = 12) at implantation. Median follow-up was 1.37 years (range 0.22-4.64y). Among subjects with initial HP, 29% (N = 2 of 7) CCB users compared to 50% (N = 2 of 4) controls subsequently lost residual hearing 3-6 months later (OR = 0.40, 95% CI = 0.04-4.32, p = 0.58). None of the four BP patients with initial HP experienced delayed loss compared to 50% (N = 2 of 4) controls with initial HP (OR = 0.00, 95% CI = 0.00-1.95, P = 0.43). Two CCB and one BP patients improved to a LFPTA <80 dB HL following initial unaided thresholds that suggested loss of residual hearing. DISCUSSION There were no significant differences in the odds of delayed loss of residual hearing with CCBs or BPs. CONCLUSION Further investigation into potential otoprotective adjuvants for maintaining residual hearing following initial successful hearing preservation is warranted, with larger cohorts and additional CCB/BP agents.
Collapse
Affiliation(s)
- Kristen L Yancey
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, USA
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Miriam Smetak
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon Isaacson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marc L Bennett
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew O'Malley
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David S Haynes
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jacob B Hunter
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| |
Collapse
|
3
|
Garabet R, Melley LE, Sataloff RT. Noninvasive Management of Voice Disorders: An Umbrella Review. J Voice 2024:S0892-1997(24)00099-7. [PMID: 38604901 DOI: 10.1016/j.jvoice.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES The aim of this study was to assess published systematic reviews that discussed noninvasive management of voice disorders. An umbrella review was conducted to collect, organize, and summarize narratively all available pharmacologic and voice therapy interventions. STUDY DESIGN Umbrella review of systematic reviews. METHODS Pertinent systematic reviews were identified by searching Pubmed/Medline and Embase. A primary screen identified studies related to voice. The second round of screening focused on studies that involved noninvasive management of voice disorders such as pharmacologic or voice therapy interventions. Variables of interest included study design, number of studies included in the review, target population, method of intervention, and outcomes. RESULTS Forty-three systematic reviews were eligible and included in the umbrella review. Ten studies focused on pharmacologic interventions, and 33 studies focused on voice therapy. Individual studies included in the systematic reviews ranged from 2-47, with a total of 601 studies overall. CONCLUSIONS This study provides a detailed review of all available systematic reviews on noninvasive management of voice disorders. Explored medications included proton pump inhibitors, calcium channel blockers, tricyclic antidepressants, antibiotics, corticosteroids, and hormone replacement. Explored voice therapy techniques included hydration, vocal function exercises, laryngeal manual therapy, respiratory exercise, biofeedback, phonation, coping strategies, and others. This may be utilized to guide therapeutic decision-making and identify current gaps in the literature that may warrant future investigation.
Collapse
Affiliation(s)
- Razmig Garabet
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Lauren E Melley
- Department of Otolaryngology - Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
| |
Collapse
|
4
|
Al-Saedi HF, Panahi Y, Ghanimi HA, Abdolmaleki A, Asadi A. Enhancement of nerve regeneration with nimodipine treatment after sciatic nerve injury. Fundam Clin Pharmacol 2023; 37:107-115. [PMID: 35989463 DOI: 10.1111/fcp.12827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 01/25/2023]
Abstract
Peripheral nerve injuries (PNI/s) are common orthopedic conditions, characterized by motor and sensory deficits in the damaged region. There is growing evidence that the L-type calcium channel antagonist nimodipine has neuroprotective and neuroregenerative effects in animal models of neurological disorders. The efficacy of nimodipine on improving motor function and sensation following a sciatic nerve crush model was investigated in male Wistar rats as a model of PNI. At different time periods following damage, we evaluated motor function, sensory recovery, electrophysiology, histomorphometry, and gene expression. Moreover, we used histological and mass ratio analysis of the gastrocnemius muscle to assess atrophy. Our findings suggest that the nimodipine improves motor and sensory function more quickly in the damaged region 2, 4, and 6 weeks after 1 week of treatment. Nimodipine treatment also increased the number of myelinated fibers while decreasing their thickness, as shown by histomorphometry. Additionally, nimodipine treatment increases the mRNA levels of neurotrophic factors (BDNF and NGF), which are known to contribute to the regeneration of injured neurons. The impact of nimodipine in PNI recovery may be due to its stimulation of the CREB signaling pathway and suppression of pro-inflammatory factor production.
Collapse
Affiliation(s)
| | - Yasin Panahi
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences (ArUMS), Ardabil, Iran
| | | | - Arash Abdolmaleki
- Department of Biophysics, Faculty of Advanced Technologies, University of Mohaghegh Ardabili, Namin, Iran
| | - Asadollah Asadi
- Department of Biology, Faculty of Science, University of Mohaghegh Ardabili, Ardabil, Iran
| |
Collapse
|
5
|
Sun X, Wang T, Zhou L, Zhang C, Fu F. The effect of triple reuptake inhibitor toludesvenlafaxine on neurological function in cerebral ischemic rats. Front Pharmacol 2023; 14:1073099. [PMID: 37153779 PMCID: PMC10160376 DOI: 10.3389/fphar.2023.1073099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
Purpose: The aim is to investigate the effect of toludesvenlafaxine (Tdv), a reuptake inhibitor of serotonin, norepinephrine, and dopamine, on the neurological function in cerebral ischemic rats and the underlying mechanisms. Material and Methods: Middle cerebral artery occlusion/reperfusion (MCAO/R) model was induced in rats and the neuroprotective effects of Tdv were evaluated by infarct size, Garcia test, and beam walking test. Neuronal apoptosis in the peri-infarct area was observed by TUNEL staining. And the apoptosis-related proteins were evaluated with Western blotting. The role of CREB pathway in effect of Tdv was also investigated using Western blotting and immunofluorescence. Results: In the MCAO/R model, administration of Tdv reduced the infarct size, promoted neural functional recovery, decreased the expression of Bax and Caspase-3, and increased the expression of Bcl-2 and BDNF. In addition, Tdv reduced neuronal apoptosis in the peri-infarct area. Tdv increased the expression of phosphorylated CREB. The application of the specific CREB inhibitor, compound 666-15, could reverse the anti-ischemic cerebral injury of Tdv in MCAO/R rats. Conclusion: Tdv ameliorated cerebral ischemic injury through reducing neuronal apoptosis and increasing the expression of BDNF via the activation of CREB pathway.
Collapse
|
6
|
Li G, Shi Y, Zhang L, Yang C, Wan T, Lv H, Jian W, Li J, Li M. Efficacy of acupuncture in animal models of vascular dementia: A systematic review and network meta-analysis. Front Aging Neurosci 2022; 14:952181. [PMID: 36062145 PMCID: PMC9434110 DOI: 10.3389/fnagi.2022.952181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/14/2022] [Indexed: 12/09/2022] Open
Abstract
Background and purpose Acupuncture is widely used in clinical practice for the treatment of vascular diseases. However, the protocol, efficacy, and mechanism of acupuncture in animal models of vascular dementia are still controversial. Based on the above problems, we initiated this comprehensive study. Methods To analyze the literatures included in this study, 4 databases were searched and the SYRCLE's Risk of bias tool was employed. To perform the subgroup analysis of different acupuncture methods and the Review Manager 5.3 was applied. Meanwhile, the pairwise and network meta-analysis were conducted using Addis 1.16.8. The outcomes included escape latency, number of crossings, time spent in the target quadrant, and swimming speed. Results Forty-two studies with a total of 1,486 animals were included in this meta-analysis. According to the results from subgroup analysis, GV20 + ST36 (Baihui + bilateral Zusanli) combined with 14-day manual acupuncture can obtain best improvement of the rats cognitive function among all acupuncture regimens (MD: -23.41; 95%CI: -26.66, -20.15; I2 = 0%; P < 0.001). The heterogeneity of other acupuncture treatments was significantly higher than that of GV20 + ST36, because the treatment courses were not uniform. Pair-wise and network comparisons are highly consistent. The major results of the network meta-analysis were as follows, In comparison to the impaired group, the acupuncture group showed significantly reduced escape latency (MD: -25.87; 95%CI: -30.75, -21.12), increased number of original platform crossings (MD: 2.63; 95%CI: 1.94, 3.34) and time spent in the target quadrant (MD: 7.88; 95%CI: 4.25, 11.44). The overall results of the network meta-analysis are as follows: the normal and sham-operated groups performed the best, followed by medicine and acupuncture, while no effect was found in the impaired group treated with non-acupoint and palliative. Conclusions Acupuncture significantly improves cognitive function in rats with vascular dementia. Compared to other acupuncture plans, (GV20 + ST36, MA) and 14 -day manual acupuncture can be used to obtain better results. The main mechanism of acupuncture in the treatment of vascular dementia is reduced oxidative stress, neuronal inflammation, and apoptosis, as well as the increased synaptic plasticity and neurotransmitters. Systematic review registration https://inplasy.com/inplasy-2021-11-0036/, identifier: INPLASY2021110036.
Collapse
Affiliation(s)
- Guangyao Li
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuling Shi
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lu Zhang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanghui Yang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ting Wan
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hang Lv
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenxuan Jian
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinghu Li
- Department of Massage, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Min Li
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
7
|
Barham M, Streppel M, Guntinas-Lichius O, Fulgham-Scott N, Vogt J, Neiss WF. Treatment With Nimodipine or FK506 After Facial Nerve Repair Neither Improves Accuracy of Reinnervation Nor Recovery of Mimetic Function in Rats. Front Neurosci 2022; 16:895076. [PMID: 35645727 PMCID: PMC9136327 DOI: 10.3389/fnins.2022.895076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Nimodipine and FK506 (Tacrolimus) are drugs that have been reported to accelerate peripheral nerve regeneration. We therefore tested these substances aiming to improve the final functional outcome of motoric reinnervation after facial nerve injury. Methods In 18 female rats, the transected facial nerve was repaired by an artificial nerve conduit. The rats were then treated with either placebo, nimodipine, or FK506, for 56 days. Facial motoneurons were pre-operatively double-labeled by Fluoro-Gold and again 56 days post-operation by Fast-Blue to measure the cytological accuracy of reinnervation. The whisking motion of the vibrissae was analyzed to assess the quality of functional recovery. Results On the non-operated side, 93–97% of those facial nerve motoneurons innervating the vibrissae were double-labeled. On the operated side, double-labeling only amounted to 38% (placebo), 40% (nimodipine), and 39% (FK506), indicating severe misdirection of reinnervation. Regardless of post-operative drug or placebo therapy, the whisking frequency reached 83–100% of the normal value (6.0 Hz), but whisking amplitude was reduced to 33–48% while whisking velocity reached 39–66% of the normal values. Compared to placebo, statistically neither nimodipine nor FK506 improved accuracy of reinnervation and function recovery. Conclusion Despite previous, positive data on the speed and quantity of axonal regeneration, nimodipine and FK506 do not improve the final functional outcome of motoric reinnervation in rats.
Collapse
Affiliation(s)
- Mohammed Barham
- Department II of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
- *Correspondence: Mohammed Barham,
| | - Michael Streppel
- Department of Ear, Nose and Throat-Department (ENT), PAN-Clinic at Neumarkt, Cologne, Germany
| | | | - Nicole Fulgham-Scott
- Department I of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
| | - Johannes Vogt
- Department II of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
| | - Wolfram F. Neiss
- Department I of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
8
|
Nimodipine Exerts Beneficial Effects on the Rat Oligodendrocyte Cell Line OLN-93. Brain Sci 2022; 12:brainsci12040476. [PMID: 35448007 PMCID: PMC9029615 DOI: 10.3390/brainsci12040476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS). Therapy is currently limited to drugs that interfere with the immune system; treatment options that primarily mediate neuroprotection and prevent neurodegeneration are not available. Here, we studied the effects of nimodipine on the rat cell line OLN-93, which resembles young mature oligodendrocytes. Nimodipine is a dihydropyridine that blocks the voltage-gated L-type calcium channel family members Cav1.2 and Cav1.3. Our data show that the treatment of OLN-93 cells with nimodipine induced the upregulation of myelin genes, in particular of proteolipid protein 1 (Plp1), which was confirmed by a significantly greater expression of PLP1 in immunofluorescence analysis and the presence of myelin structures in the cytoplasm at the ultrastructural level. Whole-genome RNA sequencing additionally revealed the upregulation of genes that are involved in neuroprotection, remyelination, and antioxidation pathways. Interestingly, the observed effects were independent of Cav1.2 and Cav1.3 because OLN-93 cells do not express these channels, and there was no measurable response pattern in patch-clamp analysis. Taking into consideration previous studies that demonstrated a beneficial effect of nimodipine on microglia, our data support the notion that nimodipine is an interesting drug candidate for the treatment of MS and other demyelinating diseases.
Collapse
|
9
|
Thielker J, Kouka M, Guntinas-Lichius O. [Preservation, reconstruction, and rehabilitation of the facial nerve]. HNO 2022; 71:232-242. [PMID: 35288765 PMCID: PMC8920054 DOI: 10.1007/s00106-022-01148-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/12/2022]
Abstract
Der Umgang mit dem N. facialis ist bei der Operation eines Parotiskarzinoms wichtig für die Langzeitlebensqualität des Patienten. In etwa 2 Drittel der Fälle ist der N. facialis nicht vom Tumor befallen. In diesen Fällen sind neben vollständiger Tumorentfernung die Identifizierung und der Erhalt des Nervs für eine erfolgreiche Operation wesentlich. Ist der Nerv vom Tumor infiltriert, muss der betroffene Teil des Nervs im Rahmen einer radikalen Parotidektomie reseziert werden. Die primäre Nervenrekonstruktion, sofern möglich, führt zu den besten funktionellen und kosmetischen Langzeitergebnissen. Das individuell optimale Therapiekonzept basiert zum einen auf der klinischen Prüfung der Gesichtsbeweglichkeit, zum anderen auf der präoperativen Bildgebung, um die Lagebeziehung zwischen Tumor und Nerv zu verstehen, und schließlich auf einer elektrophysiologischen Untersuchung zur Funktion des Nervs. Intraoperativ hilft ein standardisiertes Vorgehen, um den Nerv zu identifizieren und zu erhalten. Wenn eine radikale Parotidektomie indiziert ist, kann bereits die präoperative Diagnostik helfen, neben der einzeitigen Rekonstruktion auch die adjuvante postoperative Therapie zu planen. Das Ziel der Rehabilitation ist die Wiederherstellung von Tonus, Symmetrie und Bewegung des gelähmten Gesichts. Die Wiederherstellung des Augenschlusses hat hohe Priorität. Bei der chirurgischen Therapie von Gesichtslähmungen gab es in den letzten Jahren viele Verbesserungen. Die vorliegende Arbeit gibt einen Überblick über die jüngsten Fortschritte in der Diagnostik, den Operationstechniken und weiteren Möglichkeiten zur Protektion des gesunden N. facialis. Anderseits wird die Rehabilitation des tumorinfiltrierten N. facialis im Kontext der Behandlung von Speicheldrüsenmalignomen beschrieben.
Collapse
Affiliation(s)
- Jovanna Thielker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland
| | - Mussab Kouka
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland
| | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. .,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland.
| |
Collapse
|
10
|
Mohammad R, Huh G, Cha W, Jeong WJ. Recurrent Laryngeal Nerve Paralysis Following Thyroidectomy: Analysis of Factors Affecting Nerve Recovery. Laryngoscope 2022; 132:1692-1696. [PMID: 35043983 DOI: 10.1002/lary.30024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 12/19/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Paralysis of the recurrent laryngeal nerves (RLNs), albeit decreased over the years, leaves the surgeon helpless as there is not much that can be done once it occurs. Nimodipine has been suggested as a remedy that could accelerate the recovery of the nerve. Our study aimed to examine the factors that affect the recovery rate (RR) and time to recovery (TTR) of post-thyroidectomy RLN paralysis, with an emphasis on the use of nimodipine. METHODS A total of 197 patients who had undergone thyroid and parathyroid surgeries were retrospectively reviewed from October 2016 to August 2019. Patients who had RLN paralysis following surgery were assessed. The medical records were retrospectively analyzed to look for possible factors that may influence RLN recovery. RESULTS A total of 289 nerves were at risk. Temporary RLN paralysis rate was 7.9% while 1.7% was permanent. Age (odds ratio [OR] = 4.8) and intra-operative extra-thyroid extension (OR = 9.0) were independent risk factors for RLN paralysis. The rate of recovery was 82.1%. Loss of signal (LOS; P = .066) was a factor trending for an impact on RR but not nimodipine (P > .05). The mean TTR was 32 days. LOS, nimodipine, and steroid use, among others, were factors trending for an impact on the TTR. CONCLUSION Although not reaching statistical significance, nimodipine and steroids might influence TTR but not the RR. Larger studies are warranted to address the effect of nimodipine on the outcome of RLN paralysis. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
Collapse
Affiliation(s)
- Ramla Mohammad
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Otolaryngology and Head and Neck Surgery, Jaber Al-Ahmad Hospital, Ministry of Health, South Surra, Kuwait
| | - Gene Huh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| |
Collapse
|
11
|
Yu Y, Li Y, Jin Z, Zhao S, Xie X, Chen F. Nimodipine reduces delayed cerebral vasospasm after intracranial tumour surgery: A Retrospective Study. Clin Exp Pharmacol Physiol 2021; 48:1613-1620. [PMID: 34343357 DOI: 10.1111/1440-1681.13564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/18/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
Cerebral vasospasm (CVS) is a frequent and serious neurosurgical complication, without sufficient therapy. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduce ischaemia secondary to delayed CVS after intracranial tumour surgery. A retrospective review was performed over the years 2011 to 2012 for patients with an anterior cranial fossa tumour and underwent intracranial tumour surgery. The surgical field was soaked with nimodipine solution or normal saline. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). Follow-up was performed using the Glasgow Outcome Scale (GOS) after discharge. There were 94 patients that met the inclusion criteria. They included 50 males and 44 females, with a mean age of 49.6 years. In the nimodipine group, CVS occurred in 13 patients; 9 patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, 19 patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group but not in the nimodipine group. Nimodipine markedly improves prognosis and significantly reduces ischaemia secondary to delayed CVS after intracranial tumour surgery, as well as the risks of mortality and morbidity.
Collapse
Affiliation(s)
- Ying Yu
- Department of Neurosurgery, First Hospital of Jilin University, Jilin, China
| | - Yunqian Li
- Department of Neurosurgery, First Hospital of Jilin University, Jilin, China
| | - Zheng Jin
- Department of Neurosurgery, First Hospital of Jilin University, Jilin, China
| | - Shuai Zhao
- Department of Anesthesiology, First Hospital of Jilin University, Jilin, China
| | - Xuan Xie
- Faculty of Fisheries and Protection of Waters, South Bohemian Research Centre of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Fan Chen
- Department of Neurosurgery, First Hospital of Jilin University, Jilin, China
| |
Collapse
|
12
|
Ali Akbari Ghavimi S, Gehret PM, Aronson MR, Schipani R, Smith KW, Borek RC, Germiller JA, Jacobs IN, Zur KB, Gottardi R. Drug delivery to the pediatric upper airway. Adv Drug Deliv Rev 2021; 174:168-189. [PMID: 33845038 DOI: 10.1016/j.addr.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022]
Abstract
Pediatric upper airway disorders are frequently life-threatening and require precise assessment and intervention. Targeting these pathologies remains a challenge for clinicians due to the high complexity of pediatric upper airway anatomy and numerous potential etiologies; the most common treatments include systemic delivery of high dose steroids and antibiotics or complex and invasive surgeries. Furthermore, the majority of innovative airway management technologies are only designed and tested for adults, limiting their widespread implementation in the pediatric population. Here, we provide a comprehensive review of the most recent challenges of managing common pediatric upper airway disorders, describe the limitations of current clinical treatments, and elaborate on how to circumvent those limitations via local controlled drug delivery. Furthermore, we propose future advancements in the field of drug-eluting technologies to improve pediatric upper airway management outcomes.
Collapse
|
13
|
Chorath K, Go BC, Kaufman A, Brant J, Moreira A, Rajasekaran K. Perioperative Nimodipine to Improve Cranial Nerve Function: A Systematic Review and Meta-Analysis. Otol Neurotol 2021; 42:783-791. [PMID: 33710143 DOI: 10.1097/mao.0000000000003101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Nimodipine has emerged as a promising strategy for protection of cranial nerves following vestibular schwannoma (VS) resections. Our goal was to conduct a comprehensive analysis of clinical studies to determine the therapeutic efficacy of nimodipine in improving facial nerve and cochlear nerve function. DATABASE REVIEWED We searched PubMed, Scopus, Cochrane Clinical Trial Registry, Clinicaltrials.gov, World Health Organization's International Clinical Trials Registry Platform, and EU Clinical Trials Registry to identify clinical studies up to May 11, 2020. METHODS We included studies evaluating perioperative administration of nimodipine as a strategy to prevent or treat facial nerve or cochlear nerve dysfunction following VS resections. Primary outcomes included preservation or recovery of House-Brackman scale for facial nerve function and Hearing and Equilibrium Guidelines for cochlear nerve function at the latest follow-up visit. Secondary outcomes included adverse events and administration strategies of nimodipine. RESULTS Nine studies (603 patients) met inclusion, of which seven studies (559 patients) were included in the quantitative analysis. Overall, nimodipine significantly increased the odds of cranial nerve recovery compared with controls (odds ratio [OR] 2.87, 95% confidence intervals [CI] [2.08, 3.95]; I2 = 0%). Subgroup analysis demonstrated that nimodipine was only effective for cochlear nerve preservation (OR 2.78, 95% CI [1.74, 4.45]; I2 = 0%), but not for facial nerve function (OR 4.54, 95% CI [0.25, 82.42]; I2 = 33%). CONCLUSION Although there is evidence supporting the perioperative role of nimodipine for VS resections, more studies are warranted to help clarify the effects of nimodipine therapy on cranial nerve preservation.
Collapse
Affiliation(s)
- Kevin Chorath
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Beatrice C Go
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Adam Kaufman
- Department of Otolaryngology, Stanford University, Stanford, California
| | - Jason Brant
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alvaro Moreira
- Department of Pediatrics, University of Texas Health-San Antonio, San Antonio, Texas
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
14
|
Laryngeal Paralysis Recovered Two Years after a Head Trauma by Growth Hormone Treatment and Neurorehabilitation. REPORTS 2021. [DOI: 10.3390/reports4030019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to describe the cognitive and speech results obtained after growth hormone (GH) treatment and neurorehabilitation in a man who suffered a traumatic brain injury (TBI). Seventeen months after the accident, the patient was treated with growth hormone (GH), together with neurostimulation and speech therapy. At admission, the flexible laryngoscopy revealed that the left vocal cord was paralyzed, in the paramedian position, a situation compatible with a recurrent nerve injury. Clinical and rehabilitation assessments revealed a prompt improvement in speech and cognitive functions and, following completion of treatment, endoscopic examination showed recovery of vocal cord mobility. These results, together with previous results from our group, indicate that GH treatment is safe and effective for helping neurorehabilitation in chronic speech impairment due to central laryngeal paralysis, as well as impaired cognitive functions.
Collapse
|
15
|
Tibbetts KM, Simpson CB. Adult Bilateral Vocal Fold Paralysis. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
16
|
|
17
|
Mateos-Nozal J, Montero-Errasquín B, Sánchez García E, Romero Rodríguez E, Cruz-Jentoft AJ. High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older. J Am Med Dir Assoc 2020; 21:2008-2011. [DOI: 10.1016/j.jamda.2020.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 02/02/2023]
|
18
|
Dhillon VK, Randolph GW, Stack BC, Lindeman B, Bloom G, Sinclair CF, Woodson G, Brooks JA, Childs LF, Esfandiari NH, Evangelista L, Guardiani E, Quintanilla-Dieck L, Naunheim MR, Shindo M, Singer M, Tolley N, Angelos P, Kupfer R, Banuchi V, Liddy W, Tufano RP. Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment. Head Neck 2020; 42:3779-3794. [PMID: 32954575 DOI: 10.1002/hed.26472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Laryngeal dysfunction after thyroid and parathyroid surgery requires early recognition and a standardized approach for patients that present with voice, swallowing, and breathing issues. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to define the terms "immediate vocal fold paralysis" and "partial neural dysfunction" and to provide clinical consensus statements based on review of the literature, integrated with expert opinion of the group. METHODS A multidisciplinary expert panel constructed the manuscript and recommendations for laryngeal dysfunction after thyroid and parathyroid surgery. A meta-analysis was performed using the literature and published guidelines. Consensus was achieved using polling and a modified Delphi approach. RESULTS Twenty-two panelists achieved consensus on five statements regarding the role of early identification and standardization of evaluation for patients with "immediate vocal fold paralysis" and "partial neural dysfunction" after thyroid and parathyroid surgery. CONCLUSION After endorsement by the AHNS Endocrine Section and Quality of Care Committee, it received final approval from the AHNS Council.
Collapse
Affiliation(s)
- Vaninder K Dhillon
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University National Capital Region, Bethesda, Maryland, USA
| | - Gregory W Randolph
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Brenessa Lindeman
- Department of General Surgery, Surgical Oncology, University of Alabama, Birmingham, Alabama, USA
| | - Gary Bloom
- ThyCa: Thyroid Cancer Survivors' Association, Inc., Olney, Maryland, USA
| | - Catherine F Sinclair
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai West Hospital, New York, New York, USA
| | - Gayle Woodson
- Department of Otolaryngology-Head and Neck Surgery, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jennifer A Brooks
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lesley F Childs
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nazanene H Esfandiari
- Department of Internal Medicine, Metabolism, Endocrinology & Diabetes (MEND), University of Michigan, Ann Arbor, Michigan, USA
| | - Lisa Evangelista
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, California, USA
| | - Elizabeth Guardiani
- Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Lourdes Quintanilla-Dieck
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
| | - Matthew R Naunheim
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Maisie Shindo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
| | - Michael Singer
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Neil Tolley
- Department of Otolaryngology-Head and Neck Surgery, Imperial College NHS Trust, London, UK
| | - Peter Angelos
- Department of Surgery, University of Chicago School of Medicine, Chicago, Illinois, USA
| | - Robbi Kupfer
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Victoria Banuchi
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell School of Medicine, New York, New York, USA
| | - Whitney Liddy
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
| | - Ralph P Tufano
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
19
|
Kim SJ, Lee HY. Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature. J Korean Med Sci 2020; 35:e245. [PMID: 32743989 PMCID: PMC7402921 DOI: 10.3346/jkms.2020.35.e245] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/04/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study reviews recent literature on facial palsy guidelines and provides systematic reviews on related topics of interest. METHODS An electronic database search was performed to identify recent guidelines dealing with facial nerve palsy, systematic reviews and recent meta-analysis published between 2011 and 2019 (inclusive). The literature search used the search terms "Bell's palsy," "Ramsay-Hunt syndrome," "Facial palsy," "Facial paralysis," "Facial paresis," "Guideline," "Meta-analysis," "Systematic review," and "Randomized controlled trial." Only studies written in English were used. RESULTS The characteristics of treatment trends for facial palsy have been reviewed over the past decade. The most prominent change noted may be the shift from the conventional House-Brackmann facial nerve grading system to the Sunnybrook and eFACE systems. In addition, the results of serial meta-analyses indicate increasing agreement with the use of surgical decompression of the facial nerve. Beyond steroids or combined steroid-antiviral treatment, various novel drugs and treatments have been tried. For long-standing facial paralysis and postparetic synkinesis sequelae after facial palsy, facial reanimation has been highlighted and the necessity of new paradigms have been raised. CONCLUSION For peripheral facial paralysis, various changes have been made, not only in the facial nerve grading systems, but also in medical treatments, from surgical procedures to rehabilitation, during the last decade.
Collapse
Affiliation(s)
- Su Jin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University School of Medicine, Daejeon, Korea
| | - Ho Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
| |
Collapse
|
20
|
Anthony B, Parker N, Patel R, Halum S. Surgical Considerations for Laryngeal Reinnervation and Future Research Directions. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00294-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
Marques JA, Marronnier A, Crampon F, Lagier A, Marie JP. Early Management of Acute Unilateral Vocal Fold Paralysis: Update of the Literature. J Voice 2020; 35:924-926. [DOI: 10.1016/j.jvoice.2020.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
|