Effects of topical phenytoin on nasal wound healing after mechanical trauma: An experimental study

Laryngoscope. 2014 Dec;124(12):E449-54. doi: 10.1002/lary.24811. Epub 2014 Jun 30.

Abstract

Objectives/hypothesis: Impaired postoperative wound healing is the second most common morbidity after synechia formation in endoscopic sinus surgery. The aim of this experimental study was to investigate the potential effects of topical phenytoin on wound healing after nasal mucosal trauma in rats.

Study design: An experimental study at the Inonu University Faculty of Medicine.

Methods: Twenty-four rats were randomized into three groups: 1) phenytoin group (n = 8), 2) control group (n = 8), and 3) vehicle group (n = 8). After damaging the right nasal cavity, in the phenytoin group, 1% topical phenytoin cream was applied for 7 days. The rats in the control group did not receive any treatment. The vehicle group was treated with daily topical cold cream for 1 week. The rats were sacrificed at the end, and the nasal cavities were excised. Tissue edema and inflammatory cell infiltration were compared among the groups. Additionally, proliferating cell nuclear antigen (PCNA) and cluster of differentiation 31 (CD31) immunoexpression levels were evaluated. Furthermore, in biochemical analysis, the tissue levels of vascular endothelial growth factor and (EGF) of the groups were investigated.

Results: In the phenytoin group, tissue edema and inflammatory cell infiltration were significantly decreased, and PCNA and CD31 immunoexpression levels were more prominent (P < .001) and the tissue EGF levels were significantly higher (P < .01).

Conclusions: Topical phenytoin treatment may alter the nasal wound healing after mechanical trauma. The potential beneficial effects of topical phenytoin on nasal mucosa should be investigated by further experimental and human trials.

Level of evidence: NA.

Keywords: Nasal mucosa; animal experimentation; cluster of differentiation 31; epidermal growth factor; intranasal administration; phenytoin; proliferating cell nuclear antigen; rats; vascular endothelial growth factor; wound healing.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Topical
  • Animals
  • Anticonvulsants / administration & dosage
  • Disease Models, Animal
  • Male
  • Nasal Mucosa / drug effects*
  • Nasal Mucosa / injuries
  • Nasal Mucosa / pathology
  • Nose / injuries*
  • Nose / pathology
  • Phenytoin / administration & dosage*
  • Rats
  • Rats, Wistar
  • Wound Healing / drug effects*
  • Wounds and Injuries / drug therapy*

Substances

  • Anticonvulsants
  • Phenytoin