maxillofacial surgery showed improvement of facial nerve function to House–Brackmann grade I and II within a period of 2 months after beginning treatment.2 Regeneration times described in the literature were 2 or 3 times longer. These results coincide with the observations by Rosen and colleagues. Several retrospective and prospective clinical trials have shown a beneficial effect of nimodipine on longterm outcome of cranial nerve function after VS surgery.3–7 A pilot study with 30 patients showed that prophylactic administration was superior to an intraoperative start or to no treatment.3 The results were significant for both cochlear (P 5 0.041) and facial (P 5 0.045) nerve outcome in the group with prophylactic nimodipine treatment. Konstanze Scheller, MD1 Christian Scheller, MD2 1
Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/ Saale, Germany
Department of Neurosurgery, Martin-Luther-University of HalleWittenberg, Halle/Saale, Germany 1. Rosen CA, Smith L, Young V, Krishna P, Muldoon M, Munin M. Prospective investigation of nimodipine for acute vocal fold paralysis. Muscle Nerve 2014;50:114–118. 2. Scheller K, Scheller C. Nimodipine promotes regeneration of peripheral facial nerve function after traumatic injury following maxillofacial surgery: an off label pilot-study. J Craniomaxillofac Surg 2012;40: 427–434. 3. Scheller C, Richter HP, Engelhardt M, K€ onig R, Antoniadis G. The influence of prophylactic vasoactive treatment on cochlear and facial nerve functions after vestibular schwannoma surgery: a prospective and open-label randomized pilot study. Neurosurgery 2007;61:92–97. 4. Strauss C, Romst€ ock J, Fahlbusch R, Rampp S, Scheller C. Preservation of facial nerve function after postoperative vasoactive treatment in vestibular schwannoma surgery. Neurosurgery 2006;59:577–584. 5. Strauss C, Bischoff B, Neu M, Berg M, Fahlbusch R, Romst€ ock J. Vasoactive treatment for hearing preservation in acoustic neuroma surgery. J Neurosurg 2001;95:771–777. 6. Scheller C, Strauss C, Fahlbusch R, Romst€ ock J. Delayed facial nerve paresis following acoustic neuroma resection and postoperative vasoactive treatment. Zentralbl Neurochir 2004;65:103–107. 7. Bischoff B, Romst€ ock J, Fahlbusch R, Buchfelder M, Strauss C. Intraoperative brainstem auditory evoked potential pattern and perioperative vasoactive treatment for hearing preservation in vestibular schwannoma surgery. J Neurol Neurosurg Psychiatry 2008;79:170–175.
Published online 26 September 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/mus.24462
REPLY: TIMING OF NIMODIPINE THERAPY FOR TREATMENT OF VOCAL FOLD PARALYSIS We thank the Drs. Scheller for providing the readership of Muscle & Nerve with a more complete bibliography related to the potential clinical utility of nimodipine following nerve injury. These additional citations are important contributions to the literature regarding this medication and this topic. It may also be useful to note that we have had a follow-up paper accepted for publication that looks at optimal timing for the administration of nimodipine for acute vocal fold paralysis.1 Clark A. Rosen, MD,1 Libby J. Smith, DO,1 VyVy Young, MD,1 Priya Krishna, MD,2 3 Matthew F. Muldoon, MD, PhD 4
Michael C. Munin, MD,
Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Department of Otolaryngology, Loma Linda University, Loma Linda, CA, USA
Heart and Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
1. Sridharan S, Rosen CA, Smith LJ, Young VN, Munin MC. Timing of Nimodipine therapy for treatment of vocal fold paralysis. Laryngoscope (to be published).
Published online 26 September 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/mus.24468
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