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Results for “HYPOGLOSSAL NERVE”

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At least 163 records · Page 9Linked to original sources

PubMed2000

Laryngeal reinnervation with the hypoglossal nerve: II. Clinical evaluation and early patient experience.

OBJECTIVES/HYPOTHESIS: To determine whether the hypoglossal nerve (XII) can serve as a suitable donor for human laryngeal reinnervation. STUDY DESIGN: Prospective, nonrandomized. METHODS: Measurements were made on patients undergoing open neck procedures to determine the length of XII available and that required to perform XII-recurrent laryngeal nerve (RLN) anastomosis. The morbidity of combined XII and RLN injuries was studied using temporary lidocaine block of the ipsilateral XII in patients with unilateral vocal fold paralysis (UVFP). A pilot series of patients with UVFP who underwent XII-RLN reinnervation was evaluated for morbidity of the procedure, and for improvement in voice and swallowing. RESULTS: In 89 necks the average available length of XII was 2 cm less than that needed to reach the larynx, indicating the RLN stump must be at least 3 cm to allow tension-free anastomosis. Twenty-five patients with untreated UVFP underwent temporary lidocaine block of XII; 8 had slight changes in their speech, none had increased aspiration. Nine patients underwent XII-RLN reinnervation. Postoperative speech analysis correlated well with the findings of the temporary lidocaine block of XII. One-year follow-up of five patients showed excellent voice quality, resolution of any preoperative aspiration, and minimal morbidity. Slight adductory movement of the reinnervated vocal fold was seen during tongue thrust. Electromyography confirmed substantial polyphasic action potentials in the thyroarytenoid muscle. CONCLUSIONS: The hypoglossal nerve is a very suitable donor for reinnervation of patients with UVFP. There should be enough length for primary XII-RLN anastomosis in most patients. Donor site morbidity is acceptable. Preoperative lidocaine block of XII is a good predictor of actual donor site morbidity and could be used to assess patients undergoing facial-hypoglossal anastomosis as well.

Adolescent↗

PubMed1990

[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↗

PubMed1994

Unilateral hypoglossal nerve paralysis following the use of the laryngeal mask airway.

We report a unilateral hypoglossal nerve paralysis following the use of a laryngeal mask airway in a 62-year-old woman with rheumatoid arthritis undergoing a shoulder joint replacement. Cervical epidural anaesthesia was combined with general anaesthesia using nitrous oxide administered via a laryngeal mask airway with the patient in the right lateral decubitus position. The next morning, the patient was noted to have a right hypoglossal nerve palsy. Compression of the nerve between the laryngeal mask airway cuff, distended with nitrous oxide, and the hyoid bone, was considered to be the cause of the nerve paralysis.

Constriction↗

PubMed2000

Intramedullar stimulation of the facial and hypoglossal nerves: estimation of the stimulated site.

AIM: To determine the stimulation site of both facial and hypoglossal nerves after transcranial magnetic stimulation. METHODS: After surgical exposure of the brainstem in 22 patients with intrinsic pontine (n=9) or medullary (n=13) tumors, the facial colliculus and the hypoglossal triangle were electrically stimulated. The EMG responses were recorded with flexible wire electrodes from the orbicularis oculi/orbicularis oris muscles, and genioglossal muscles. Patients had no preoperative deficit of the nerves. RESULTS: The EMG mean latencies of the unaffected facial nerve were 5.2+/-0.6 ms for the orbicularis oculi, and 5.2+/-0.5 ms for the orbicularis oris muscle. After the stimulation of 18 possibly affected facial nerves, the EMG mean latencies were 5.3+/-0.3 ms for the orbicularis oculi (p=0.539, unpaired Student's t-test), and 5.4+/-0.2 ms for the orbicularis oris (p=0.122). The EMG mean latency of the unaffected hypoglossal nerve was 4.1+/-0.6 ms for the genioglossal muscle. After the stimulation of 26 possibly affected hypoglossal nerves, the EMG mean latency for the genioglossal muscle was 5.3+/-0.3 ms. There was a significant difference (p<0.001) in latency for genioglossal EMG responses between the patients with pontine and those with medullary tumors. CONCLUSION: Shorter EMG mean latencies of unaffected facial nerves obtained after direct stimulation of the facial colliculi confirm that magnetic stimulation is most likely to occur closer to the nerve's exit from the brainstem than to its entrance into the internal auditory meatus. The hypoglossal nerve seems to have the site of excitation at the axon hillock of the hypoglossal motor neurons.

Adolescent↗

PubMedDate not supplied

Isolated hypoglossal nerve palsy in a child.

We report an 11-year-old boy who had isolated hypoglossal nerve palsy one week after symptoms and signs of urticarial lesions. Neuroradiological examinations and other investigations for etiology of hypoglossal nerve palsy and urticaria were normal. We suggest that all patients with hypoglossal palsy must be carefully evaluated for atypical findings and etiologies.

Child↗

PubMed2001

[Hypoglossal nerve palsy and infectious mononucleosis].

Neurologic manifestations are infrequent in infectious mononucleosis and specially hypoglossal nerve involvement is very rare. To the best of our knowledge only 6 cases have been previously reported. We describe herein the case of a 20-years-old man who presented an unilateral hypoglossal nerve palsy secondary to infectious mononucleosis. He was treated i.v. steroids without recovery, but the palsy resolved spontaneously 2 months after the onset.

Adult↗

PubMed2002

Hypoglossal nerve palsy as complication of oral intubation, bronchoscopy and use of the laryngeal mask airway.

Hypoglossal nerve injury is a recognized but rare complication of oropharyngeal manipulation during intubation, bronchoscopy and use of a laryngeal mask airway. We present 2 new cases of temporary hypoglossal nerve palsy after orotracheal intubation for general anesthesia. The relevant literature is reviewed and different hypotheses concerning the pathophysiological mechanisms of nerve damage are discussed.

Adult↗

PubMed1990

Depressant effect of raphe stimulation on inspiratory activity of the hypoglossal nerve: in vitro study in the newborn rat.

Respiratory activity was recorded from the hypoglossal nerve and cervical ventral roots of the superfused isolated brainstem and spinal cord of the newborn rat in order to investigate the effects of serotonin (5-HT). Three experimental procedures were used: (i) brainstem superfusion by exogenous 5-HT (previously reported), (ii) electrical stimulation of pontine midline structures, and (iii) pressure microejection of L-glutamate at the same sites. Each of the experimental procedure increased respiratory frequency and depressed the amplitude of the discharge of the hypoglossal nerve more than that of the cervical roots. These results indicate that 5-HT acts centrally to modulate the activity of the respiratory generator and inhibits the hypoglossal activity. A possible involvement of 5-HT mediated inhibition in obstructive apnea is discussed.

Animals↗

PubMed1999

Expression of gicerin, a novel cell adhesion molecule, is upregulated in the astrocytes after hypoglossal nerve injury in rats.

Gicerin is an integral membrane glycoprotein which mediates cell-cell and cell-extracellular matrix (ECM) interactions in the nervous system. We studied gicerin expression in the hypoglossal nucleus post transection using in situ hybridization and immunocytochemistry. We found that hypoglossal nerve injury resulted in a significant increase in gicerin expression. Its expression levels reached peak values in reactive astrocytes surrounding axotomized motoneurons of the ipsilateral hypoglossal nucleus 14 days after hypoglossal nerve injury. The results indicate that gicerin is up-regulated during nerve regeneration, suggesting that gicerin expressed in the reactive astrocytes might be involved in the processes of nerve regeneration.

Animals↗

PubMed1978

Uptake and retrograde axonal transport of various exogenous macromolecules in normal and crushed hypoglossal nerves.

Macromolecular tracers were injected into the tongue or around a crush in mouse hypoglossal nerves. At various times thereafter, the tracers were histochemically localized on the basis of peroxidase activity. The distribution of reaction product was then examined using light microscopy in order to study the influence of molecular charge and size on uptake and retrograde axonal transport from the periphery or from the crushed axon. Of various proteins with peroxidase activity, horseradish peroxidase and cytochrome-c showed the greatest penetration into axons proximal to the crush. Following injection into the tongue, intra-axonal cytochrome-c was detectable in some of the peripheral branches but not any of the other proteins. Retrograde transport to the nerve cell bodies was demonstrated for horseradish peroxidase and cytochrome-c, both from the tongue and from the axonal crush but not for microperoxidase, myoglobin, hemoglobin, lactoperoxidase and catalase. The number of neuronal cell bodies having detectable reaction product was higher for peroxidase-injected than for cytochrome-c-injected animals. Ferritin and iron-dextran (Imferon) also accumulated in hypoglossal neurons, but this could be detected only after repeated injections into the tongue. Uptake and retrograde transport from the tongue or from the crush occurred both for anionic and for cationic horseradish peroxidase. This is interpreted as evidence against absolute specificity in the uptake and transport of macromolecules on the basis of electrical charge.

Animals↗

PubMed1983

The effects of hypercapnia and hypoxia on single hypoglossal nerve fiber activity.

The respiratory related modulation of hypoglossal nerve activity has been studied at the single fiber level in cats under hyperoxic hypercapnia and hypoxic conditions and their conduction velocities determined. Changes in fiber activity were compared to simultaneous changes occurring in phrenic activity. Three different kinds of discharge patterns were observed: (a) inspiratory, (b) phasic activity during both inspiration and expiration, and (c) continuous random activity with no respiratory modulation. These fibers could be grouped into three categories according to their pattern of discharge during CO2 breathing. Type I fibers, mean conduction velocity of 30.0 m/sec, exhibited only an inspiratory phasic discharge during 100% O2 breathing. Their discharge frequency increased rapidly with higher levels of CO2 and hypoxia. Type II fibers, mean conduction velocity of 36.7 m/sec, had three different kinds of inspiratory-expiratory discharge patterns during 100% O2 breathing. With increasing hypercapnia or hypoxia fibers of this group discharged phasically during inspiration and discharge at low frequency during expiration. Type III fibers had a non phasic discharge pattern at 100% O2 breathing and at all levels of CO2 tested (up to 10%). Discharge frequency rose during CO2 rebreathing and hypoxia, but the rate of increase was much less than Type I and Type II fibers. Their mean conduction velocity was 41.3 m/sec. The inspiratory activity of Type I and II fibers increased their activity more than the phrenic during hypercapnia and hypoxia. Type II and Type III fibers are responsible at least in part for the tonic activity of the nerve.

Animals↗

PubMed1990

Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis. Demonstration by CT and angiography.

A case of pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis resulting from trauma is presented. CT and angiographic manifestations of this pseudoaneurysm and the resulting hypoglossal nerve paralysis are discussed. Correlative CT and angiographic findings of this association have not previously been described in the literature.

Carotid Artery Diseases↗

PubMed2004

Bilateral hypoglossal nerve injury following the use of the laryngeal mask without the use of nitrous oxide.

Hypoglossal nerve injury is a rare complication of anaesthesia airway management in adults. Until now the use of nitrous oxide for anaesthesia supposedly contributed to this complication. We present a case of bilateral hypoglossal nerve injury following the use of a laryngeal mask airway without the use of nitrous oxide. At the conclusion of 3 h of surgery in extreme side rotation, a 15-year-old boy of 88 kg could not extend his tongue beyond his teeth. An MRI confirmed the absence of pharyngeal haematoma and the absence of thrombosis of the basilar artery. We conclude that even when patients have no medical history and nitrous oxide is not being used, prolongation of the operation in an extreme position might increase the risk of major complications with a laryngeal mask.

Adolescent↗

PubMed1986

A note on the anastomoses between the hypoglossal nerve and the cervical plexus.

A series of 80 dissections was performed to define the anastomoses between the cervical plexus and the hypoglossal nerve (XII), the superior anastomosis between the trunk of XII and the ansa of the atlas from the cervical plexus; the ansa cervicalis, traditionally known as the ansa of the XIIth cranial nerve or hypoglossal ansa, formed by the direct junctional anastomosis of the descending branch of XII and the internal descending branch of the cervical plexus. The origins, form, branches and chief relations are defined in in the present study.

Cervical Plexus↗

PubMed1990

Afferent fibers in the hypoglossal nerve: a horseradish peroxidase study in the cat.

The existence of afferent fibers in the cat hypoglossal nerve was studied by transganglionic transport of horseradish peroxidase (HRP). Injections of wheat germ agglutinin-conjugated HRP (WGA-HRP) into the hypoglossal nerve resulted in some retrograde labeling of cell bodies within the superior ganglia of the ipsilateral glossopharyngeal and vagal nerves. A few labeled cell bodies were also present ipsilaterally within the inferior ganglion of the vagal nerve and the spinal ganglion of the C1 segment. Some of the labeled glossopharyngeal and vagal fibers reached the nucleus of the solitary tract by crossing the dorsal portion of the spinal trigeminal tract. Others distributed to the spinal trigeminal nucleus pars interpolaris and to the ventrolateral part of the medial cuneate nucleus by descending through the dorsal portion of the spinal trigeminal tract. In the spinal cord these descending fibers, intermingling with labeled dorsal root fibers, distributed to laminae I, IV-V and VII-VIII of the C1 and C2 segments. Additional HRP experiments revealed that the fibers in laminae VII-VIII originate mainly from dorsal root of the C1 segment.

Animals↗

PubMed2000

Effect of ethanol upon respiratory-related hypoglossal nerve output of neonatal rat brain stem slices.

The actions of ethanol (EtOH) on the respiratory output of the neonatal rat brain stem slice preparation in vitro are described. Ethanol inhibited respiratory-related hypoglossal nerve activity in a dose-dependent manner. The effect of EtOH was evident within 5 min and was reversible on EtOH washout. The actions of EtOH were qualitatively similar to those of two other alcohols, methanol and octanol. We investigated the dose-response relationship for each alcohol and determined that the order of potency was methanol < EtOH << octanol, with EC(50) values of 291 mM, 39.7 mM, and 49.2 microM respectively. Application of either strychnine (5 microM) or bicuculline (5 microM) alone, partially but not significantly, reversed the inhibition of respiratory-related hypoglossal nerve activity produced by 50 mM EtOH. Preincubation of rhythmic slices with a combination of both strychnine and bicuculline (both 5 microM) partially, but significantly, blocked the inhibitory actions of EtOH, suggesting that other mechanisms also play a role in the action of EtOH. Preincubation of the slices with 25 microM APV reduced the relative degree of inhibition caused by EtOH suggesting that N-methyl-D-aspartate (NMDA)-receptor-mediated events can be affected by EtOH. Furthermore inhibition of protein kinase C by incubation with 100 nM staurosporine also reduced the efficacy of EtOH. These results suggest that the actions of EtOH may be mediated via glycine, GABA(A), and NMDA receptors and that activation of protein kinase C is involved in the EtOH-induced inhibition of respiratory-related hypoglossal nerve activity.

6-Cyano-7-nitroquinoxaline-2,3-dione↗

PubMed2006

Surgical anatomy of the cervical segment of the hypoglossal nerve.

The surgical anatomy of the extracranial segment of the hypoglossal nerve (HN) has been sparsely investigated in the literature. This article studies the course and anatomical and topographic relationships of the HN in 23 formalin fixed cadavers bilaterally dissected under a surgical microscope. The descriptive anatomy is presented with relevant clinical and surgical implications.

Aged↗

PubMed2002

Isolated unilateral hypoglossal nerve palsy after minor head trauma.

Isolated unilateral hypoglossal nerve palsy after fracture of the occipital condyle is rare. It usually occurs after major trauma, such as high-speed deceleration injuries following road traffic accidents. We describe a case that resulted from minor trauma. An underlying skull base malformation may have been a predisposing factor.

Accidents, Traffic↗