Does Creatine Improve Corticosteroid-Mediated Facial Nerve Healing in a Rat Model?

Abstract

To evaluate the effects of creatine monohydrate and methylprednisolone, administered individually or in combination, on functional and structural recovery following experimental facial nerve crush injury in rats. Forty Wistar albino rats were randomly allocated into five groups: control (Group 0), trauma only (Group 1), trauma plus creatine monohydrate (Group 2), trauma plus methylprednisolone (Group 3), and trauma plus combined therapy (Group 4). A standardized crush injury was induced in the marginal mandibular branch of the facial nerve. Electrophysiological assessments were performed pre-injury, immediately after injury, and on postoperative Day 28. Histopathological evaluation was conducted using light and transmission electron microscopy. Baseline and immediate post-injury electrophysiological measurements were comparable among trauma groups. On postoperative Day 28, significant improvement in latency values and compound muscle action potentials (CMAPs) was observed in Groups 3 and 4 compared with post-injury measurements (p = 0.0001). Histopathological analysis demonstrated reduced myelin degeneration in Group 4 compared with Groups 1 and 2 (p = 0.006 and p = 0.005). Endothelial morphology in Group 4 was comparable to Group 0, whereas increased endothelial cell height was observed in other trauma groups. Overall histomorphological recovery in Group 4 most closely resembled Group 0. Combined administration of creatine monohydrate and methylprednisolone resulted in superior histopathological recovery compared with monotherapy. While corticosteroids improved electrophysiological outcomes, the addition of creatine enhanced structural preservation, supporting its role as an adjunct therapy. N/A.