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Trophic specificity of the gustatory fibers upon taste bud regeneration.

24 adult dogs were classified into six groups; in 2 animals of each group the lingual nerve was transected distal to the point of entry of the chorda tympani and its proximal end was sutured to the distal end of the glossopharyngeal nerve. In the other 2 animals transtympanic chorda tympani neurectomy was performed before suturing the lingual and glossopharyngeal nerves. Invasion of the papillae by regenerating fibers from the 8th postoperative week onwards was followed by reappearance of taste buds only in lingual glossopharyngeal anastomosis with intact chorda tympani. The difference in number of taste buds, size and number of constituent cells between the two operative procedures was statistically significant from the 8th week onwards. The significance of these findings was discussed.

Animals↗

Capsaicin induces cystatin S-like substances in submandibular saliva of the rat.

Irritating dietary substances such as tannin and papain have been reported to alter the morphology of salivary glands and their secretions. Such alterations can be one line of protection from toxic or irritating substances in food. We investigated the effects of dietary capsaicin (a pungent ingredient of hot red pepper) on the rat submandibular gland and its secretions. Several groups of animals were offered either control diets or diets containing capsaicin (from 0.0001 to 0.1%) for seven days. Higher concentrations suppressed food consumption for two days, after which only the highest concentration continued to reduce intake. The relative weight of the salivary glands in capsaicin-diet groups increased in a dose-dependent fashion, and new proteins appeared in the submandibular saliva. Chromatographic and electrophoretic properties of these proteins were identical or similar to those of isoproterenol-induced proteins. After affinity chromatography of the new protein fraction on a Cm-papain Sepharose 4B column, SDS-electrophoresis of the eluate revealed three major bands (15,500, 16,500, and 28,000 kDa). Hydrolysis of N-benzoyl-D,L-arginine-p-nitroanilide by papain (a cysteine protease) decreased in the presence of the new protein fraction, suggesting that these proteins have cystatin-like activity (inhibition of cysteine protease). Denervation of the glossopharyngeal nerve suppressed induction of these proteins. The results suggest that dietary capsaicin induces cystatin S-like substances in submandibular saliva by stimulating the reflex arc involving the glossopharyngeal nerve. These proteins likely facilitate ingestion of diets containing the irritating substance.

Analysis of Variance↗

[Variations of the constrictor pharyngeal muscles in humans].

Fifteen halves of ten nonrandomized human cadavers were dissected under a stereoscopic microscope in order to examine the existence of variations in the constrictor pharyngeal muscles. Obvious variations of the constrictor muscles were found in three cases. The results are summarized as follows: 1. In the first case of variations, the superior constrictors arose from the pterygomandibular raphe and merged into the outer surfaces of the middle and inferior constrictors. This muscle was supplied by the upper part of the pharyngeal branches of the vagus. 2. In the second case, the muscle bundle of inferior constrictors originated from the thyroid cartilage and passed upward, joining the muscular fibers of the outer surface of the superior constrictors arising from the pterygomandibular raphe. Some of these muscular fibers extended to the surface of the posterior part of the pharyngobasilar fascia. This muscle was innervated by the lower part of the pharyngeal branches of the vagus. 3. In the third case, the lower part of the superior constrictors passed laterally between the stylopharyngeus and the glossopharyngeal nerve, running between the external and internal carotids in the retrostyloid space and reaching the cervical fascia around the submandibular triangle. This anomalous muscular bundle of superior constrictors was innervated by the carotid branch of the glossopharyngeal nerve and the middle part of the pharyngeal branches of the vagus.

Glossopharyngeal Nerve↗

Developmental organization of the glossopharyngeal nucleus in the embryonic chick brainstem slice as revealed by optical sectioning recording.

We traced developmental changes in the ventro-dorsal distribution pattern of glossopharyngeal nerve (N. IX) responses by applying an optical sectioning method to thick slice preparations dissected from E4 to E8 chick embryos. We identified the motor and sensory nuclei related to the glossopharyngeal nerve in the rostral and caudal focal planes, respectively. In the E4 and E5 preparations, the motoneuronal responses appeared on the central part of the stimulated side of the brainstem. As development proceeded to E6, the response area became localized on the dorsal region. The change in the ventro-dorsal distribution pattern was similar to that observed in the vagus nerve-related nuclei, suggesting that there might be an essential process underlying functional organization of the brainstem nuclei.

Animals↗

Reflex vasodilatation in the cat lip evoked by stimulation of vagal afferents.

In 36 cats under nembutal anaesthesia, stimulation of the central end of the cut vagus nerve caused blood flow to increase in only the ipsilateral side in six cats (17%) and in the bilateral sides in 30 cats (83%) in the lower lips. Pretreatment with hexamethonium to block nicotinic synapses in autonomic ganglia resulted in a time-dependent reduction of the reflex vasodilator response, while phentolamine, propranolol (alpha-, beta-adrenoreceptor antagonists) and tripelennamine (histamine receptor antagonist) had no effect. Pretreatment with atropine (muscarinic receptor antagonist) showed a slight, but not statistically insignificant attenuation of the reflex vasodilatation. Ipsilateral section of either the glossopharyngeal nerve root or the inferior alveolar nerve completely abolished the reflex vasodilator response elicited by central vagal stimulation. The reflex vasodilator response induced by stimulation of the central end of the cut vagus nerve was abolished by topical capsaicin application on the central cut ends of the vagus nerve but not by capsaicin on the inferior alveolar nerve. These results suggest that there is a cutaneous reflex vasodilator system that can be activated via capsaicin-sensitive afferent fibres in the vagus nerve. Parasympathetic vasodilator fibres of this system emerge from the brain stem with the glossopharyngeal nerve and reach the blood vessels in the cat mandibular lip via the inferior alveolar nerve.

Animals↗

Microvascular decompression for glossopharyngeal neuralgia.

Glossopharyngeal neuralgia is an uncommon cause of facial pain with a relative frequency of 0.2 to 1.3% when compared with trigeminal neuralgia. It is characterized by intermittent, lancinating pain involving the posterior tongue and pharynx, often with radiation to deep ear structures. Since its first description in 1910 by Weisenburg, a variety of destructive procedures have been performed to provide relief in patients whose pain was refractory to medical treatment. These procedures all necessitated the sacrifice of the glossopharyngeal nerve and, in most cases, also involved the destruction of at least part of the vagus nerve as well. In 1977, Laha and Jannetta reported good results in four patients who underwent microvascular decompression of the glossopharyngeal and vagus nerves for glossopharyngeal neuralgia. Since 1971, 40 patients have undergone microvascular decompression of the glossopharyngeal and vagus nerves for treatment of typical glossopharyngeal neuralgia. This procedure provided excellent immediate results (complete or > 95% relief of pain) in 79%, with an additional 10% having a substantial (> 50%) reduction in pain. Long-term follow-up (mean, 48 mo; range, 6-170 mo) reveals excellent results (complete or > 95% reduction in pain without any medication) in 76% of the patients and substantial improvement in an additional 16%. There were two deaths at surgery (5%) both occurring early in the series as the result of hemodynamic lability causing intracranial hemorrhage. Three patients (8%) suffered permanent 9th nerve palsy. (ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Calbindin D28k-like immunoreactivity in the developing and regenerating circumvallate papilla of the rat.

The distribution of calbindin D28k (CB)-like immunoreactivity (-LI) in the circumvallate papilla (CVP) was examined during development and regeneration following bilateral crush injury to the glossopharyngeal nerve in the rat. In the adult CVP, CB-like immunoreactive (-IR) nerve fibers were observed in the subgemmal region and some penetrated into the taste buds. CB-LI was also detected in the cytoplasm of the spindle-shaped gustatory cells in the lower half of the trench epithelium, which contained numerous synaptic vesicles and bundles of intermediate filaments. These CB-IR gustatory cells made synapse-like contacts with CB-IR nerve terminals. Some CB-IR nerve terminals made contacts with the gustatory cells negative for CB-LI. At least three developmental stages were defined with regard to the developmental changes in the distribution of CB-LI: (1) Stage I (embryonic day (E) 18-postnatal day (P)5): CB-IR nerve fibers appeared in the lamina propria just beneath the newly-formed CVP at E18, but the gustatory epithelium of the CVP contained no CB-IR structures. Taste buds with taste pores appeared at P1. (2) Stage II (P5-10): thin CB-IR nerve fibers began entering the trench epithelium, but no CB-IR cells were observed. (3) Stage III (P10-adult): in addition to the intragemmal and perigemmal CB-IR nerve fibers, very few CB-IR cells appeared in the taste buds around P10, and their numbers increased progressively. The changes in the distribution of taste buds and CB-LI following glossopharyngeal nerve injury were similar to those observed during development. On post-operative day (PO) 4, the taste buds and CB-IR cells decreased markedly in number. These CB-IR cells became round in shape, and the number of CB-IR nerve fibers decreased markedly. On PO8, both taste buds and CB-IR cells disappeared completely. The regenerated taste buds were first observed on PO12, increased rapidly in number by PO20, and increased slowly thereafter. CB-IR nerve fibers accumulated at the subgemmal region and began penetrating into the trench wall epithelium around PO16. CB-IR cells appeared between PO20 and PO24, and their numbers increased progressively and reached the normal level on PO40. The topographical localizations of the taste buds and CB-IR cells during development and regeneration were comparable to those of normal animals. The delay of the time courses for appearance of CB-IR nerve fibers and CB-IR cells compared to the appearance of taste buds during development and regeneration suggests that CB in the gustatory epithelium may participate in the survival of the taste bud cells rather than in the induction of the taste buds.

Age Factors↗

Intraoral nerve block for glossopharyngeal neuralgia.

Glossopharyngeal neuralgia was treated by a new method of intraoral block. The procedure consists of block for the tonsillar branch and block of the lingual branch by the injection of 5% Phenol in Glycerin. This can be applied for neuralgia with a trigger zone around the tonsil. The result is quite satisfactory. This is extremely safe and simple, and can be performed repetitively when recurrences occur. Also, this procedure does not preclude later operations as a final step.

Analgesics↗

Unilateral anomalous left common carotid artery; a case report.

An anomaly of the left common carotid artery was observed in a Japanese male cadaver during an anatomy class at the Saitama Medical School in 1995. The superior thyroid, lingual and facial arteries arose from the common carotid artery, and the posterior auricular, maxillary and superficial temporal arteries arose from the common carotid artery by a common trunk. The occipital and ascending pharyngeal arteries arose from the internal carotid artery. The left carotid body (glomus caroticum) was observed to be slightly below the lingual artery, behind the common carotid artery, and it was located at the level of the intervertebral disk between C2 and C3 or at the same level as the right carotid body. The carotid body was richly innervated by a branch of the glossopharyngeal nerve and by a plexus of sympathetic fibers from the vagus and glossopharyngeal nerves. We assumed that the artery above the level of the carotid body was the internal carotid artery; there was no specific external carotid artery and all branches of the external carotid artery arose from the internal carotid artery.

Aged↗

[Hypoglossal nerve paralysis following tonsillectomy].

Lesions of the lingual nerve and the glossopharyngeal nerve following tonsillectomy are rare but can be expected because of their anatomical course. What is extremely rare is a lesion of the hypoglossal nerve, whose course behind the carotid artery protects it from direct injury. The few cases described in the literature are thought to have been caused by inflammatory processes. It became necessary to look for other causes when, after a regular tonsillectomy, a hypoglossal palsy became evident in the absence of any inflammation. In an experiment, it was possible to demonstrate that both the insertion of a spatula and of an intubation spatula caused a strain of the hypoglossal nerve when the spatulas were inserted in the lateral lingual region. The nerve was distended by as much as 1.3 cm. The more the head was reclined, the more the nerve was distended. It would seem probable that this extension of the hypoglossal nerve causes its palsy following tonsillectomy.

Adult↗

Microsurgical anatomy around the foramen of Luschka in relation to intraoperative recording of auditory evoked potentials from the cochlear nuclei.

Three cadaveric heads were dissected to investigate the microsurgical anatomy around the foramen of Luschka. It was found possible to place a recording electrode in proximity to the cochlear nuclei by inserting it in the lateral recess of the fourth ventricle through the foramen of Luschka. In operations of the cerebellopontine angle using the retromastoid approach, access to the foramen of Luschka and the lateral recess is obtained by retracting the biventral lobule of the cerebellum in a caudal-rostral direction under a caudal-rostral/medial field of vision. The craniectomy might need to be enlarged a few millimeters in the caudal direction. A wick electrode can be inserted in the lateral recess beneath the choroid plexus in a rostromedial direction and to a depth of approximately 3 to 5 mm from the foramen of Luschka without excessive retraction of the cerebellum. The optimum position for the recording electrode is in the triangle formed by the axis of the cochlear nerve and the glossopharyngeal nerve and by the lip of the foramen of Luschka. The caudal retromastoid approach is more suitable than the translabyrinthine technique for recording from the cochlear nuclei as well as for implantation of stimulating electrodes into the cochlear nuclei for use as hearing prostheses.

Cadaver↗

[One stage removal of huge glomus tumor].

Surgical removal of a huge glomus jugular tumor has been considered as one of the most difficult skull base surgeries not only because of the difficulty in approaching the tumor, but also because of its highly vascular nature and various possible postoperative complications. We used combined infratemporal fossa and lateral suboccipital approach in a single stage to operate on a 49-year-old male with a huge glomus jugular tumor, which extended from the right cerebellopontine angle to the level of the the third vertebra. With this approach we could expose the tumor extensively and control the feeding arteries easily in spite of marked vascularity of the tumor. Retraction of the cerebellum was only minimal owing to the removal of the petrous bone. The tumor was excised not by piecemeal but in en block manner with preservation of all the cranial nerves but the glossopharyngeal nerve. To prevent postoperative cerebrospinal fluid leakage, the following procedures were very useful; 'blind sack closure' of the external auditory canal, careful closure of the Eustachian tube, use of the pedicled muscle flap from the temporal and the sternocleidomastoid muscle, use of fibrin glue at the time of the wound closure, and placement of preventive spinal drainage. The patient was discharged with hoarseness and facial palsy. However these symptoms had almost completely disappeared within one year. He is working in the same occupation as before.

Cerebellar Neoplasms↗

[Obscure otalgias].

The author draws attention to the possible development of otalgia beyond the organ of hearing. He mentions the development of otalgia in vertebrogenic and dental diseases and the possibility of the development of otalgia as a result of diseases localized beyond the organ of hearing, innervated by the trigeminal nerve, vagus or glossopharyngeal nerve.

Adult↗

[Paralysis of the hypoglossal nerve after tonsillectomy? (author's transl)].

While injuries of the lingual nerve and the glossopharyngeal nerve in tonsillectomy are possible, a lesion of the hypoglossal nerve is not understandable because of its anatomical course. To see a connection between the lesion of the nerve and a tonsillectomy is probably due to a wrong anatomical concept or incorrect topographical figures. Seen from the oral cavity, the hypoglossal nerve lies behind the great arteries and has, in the region of the floor of the mouth, no direct connection with the tonsil. The medicolegal aspects are reported. Lesion of the hypoglossal nerve might be possible only in bronchoscopy or in direct laryngoscopy.

Adult↗

[Intraoperative monitoring of the lower cranial nerves during skull base surgery: evoked electromyographic technique].

Functional preservation of the lower cranial nerves is an important issue in the surgery of the skull base to avoid postoperative serious complications such as aspiration pneumonia and respiratory disorders. We presented our experience of intraoperative monitoring of the lower cranial nerves during skull base surgery. The evoked electromyographic (EMG) activities were successfully recorded from the muscles innervated by the lower cranial nerves. These EMG recordings are helpful to guide the surgeon intraoperatively and to avoid careless severing of these nerves. Although the glossopharyngeal nerve that innervates only one small muscle in the pharynx (M. stylopharyngeus) cannot be monitored with the evoked EMG technique described in this paper, the position of this nerve can be deduced from the position of the vagus nerve.

Adult↗

The consequences of gustatory nerve transection on taste-guided licking of sucrose and maltose in the rat.

Lick responses to sucrose and maltose (0.01-1.0 M) were measured in nondeprived rats during brief-access taste trials before and after histologically confirmed gustatory neurotomy. Pronounced decreases in sugar responsiveness occurred after combined section of the chorda tympani (CT) and greater superficial petrosal nerves. The additional section of the glossopharyngeal nerve (GL) flattened the sucrose concentration-response function. Extirpation of the sublingual and submaxillary salivary glands also attenuated sugar responsiveness. Section of the CT or GL alone or in combination caused less severe or no decreases in sugar licking. There were signs of licking impairments after some of these neurotomies, but the data suggest that changes in sugar responsiveness were not solely motor in origin. Thus the 7th nerve is necessary and most likely sufficient for the maintenance of normal unconditioned appetitive responsiveness to sucrose and maltose.

Animals↗

The ionic basis of the receptor potential of frog taste cells induced by water stimuli.

The ionic mechanism underlying the receptor potential induced by a deionized water stimulus was studied in frog taste cells with conventional microelectrodes. The taste cells located in the proximal portion of the tongue generated a depolarizing receptor potential which averaged 10mV in response to stimulation with deionized water. The cell membrane of the water-sensitive taste cell could be divided into the taste-receptive (apical) and basolateral membranes and the cells were classified into two types: Cl(-)-dependent and Cl(-)-independent. In Cl(-)-dependent cells whose input resistance was decreased or unchanged by deionized water, the magnitude of the water-induced depolarization decreased with an increase in concentration of superficial Cl- in contact with the receptive membrane and with addition of blockers of anion channels (0.1 mmol l-1 SITS and 0.1 mmol l-1 DIDS) to deionized water. The reversal potential for the depolarization in this type shifted according to the concentration of superficial Cl-. These properties of the responses were consistent with those of the glossopharyngeal nerve which innervates the taste disc. In Cl(-)-independent cells whose input resistance was increased by deionized water, the reversal potential was approximately equal to the equilibrium potential for K+ at the basolateral membrane. The water-induced response of the glossopharyngeal nerve was decreased to about 60% of the control value by addition of interstitial 2 mmol l-1 Ba2+. It is concluded that the water-induced receptor potential is produced by Cl- secretion through the taste-receptive membrane in about 70% of water-sensitive frog taste cells, while it is generated by an inhibition of the resting K+ conductance of the basolateral membrane in the remaining 30% of the cells.

Action Potentials↗