Nimodipine improves vocal fold and facial motion recovery after injury: A systematic review and meta‐analysis

• Published in: The Laryngoscope 2019-04, Vol.129 (4), p.943-951
• Main Authors: Lin, R. Jun, Klein‐Fedyshin, Michele, Rosen, Clark A.
• Format: Article
• Language: English
• Subjects: facial nerve injury; Larynx; Meta-analysis; Nimodipine; Paralysis; Systematic review; vocal cord paralysis; vocal fold paralysis
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.27530

Introduction Nimodipine is a calcium channel blocker that has been used to treat hypertension and vasospasm. Emerging evidence in the literature suggests that it is neuroprotective by reducing cellular apoptosis after neuronal injury and promoting axonal sprouting at the nodes of Ranvier. Objectives To conduct a systematic review of the usage of nimodipine in cranial nerve injury and to perform a meta‐analysis to estimate the efficacy of nimodipine on functional recovery of the injured cranial nerves. Methods Literature search was performed in eight databases using preferred reporting items for systematic reviews and meta analyses (PRISMA) guidelines. Human studies that used nimodipine as a monotherapy for treating cranial nerve injury were included for review. Cranial nerve function recovery was the primary outcome measure. Results 672 records were screened and 58 full texts in English were assessed. Nine studies were included in the final review. 5 of these, including 110 participants who received nimodipine for either recurrent laryngeal nerve or facial nerve injury and 556 controls, were used for meta‐analysis. Nimodipine significantly increased the odds of vocal fold motion recovery (odds ratio [OR] 13.73, 95% confidence interval [CI] 6.21, 30.38, P