[Impaired motor functions. Surgical and conservative procedures for restoring motor functions of the facial nerve, accessory nerve, hypoglossal nerve].
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Accessory Nerve Diseases↗
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Results for “HYPOGLOSSAL NERVE”
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Cellular dumbbell schwannoma of the hypoglossal nerve presenting without hypoglossal nerve palsy.
A rare case of cellular schwannoma of the hypoglossal nerve, with intraspinal extension, presenting without any recognisable impairment of the function of the hypoglossal nerve is presented.
Adult↗
Effects of increasing depth of anaesthesia on phrenic nerve and hypoglossal nerve activity during the swallowing reflex in cats.
The effects of increasing depths of anaesthesia on phrenic nerve (PN) activity and hypoglossal nerve (HN) activity during the swallowing reflex elicited by stimulation of the superior laryngeal nerve (SLN) were investigated in 10 cats. Swallowing induced by SLN stimulation always coincided with a characteristic brief burst of PN activity and a large amplitude burst of HN activity. These characteristic responses of PN and HN activities were not influenced by either bilateral vagotomy or neuromuscular blockade, indicating that the characteristic responses of PN and HN activities can be used as indicators of the swallowing reflex in vagotomized and paralysed animals. The results obtained in such animals showed that increasing depth of anaesthesia depressed progressively the swallowing reflex. Detailed analysis of HN activity revealed also that SLN stimulation elicited three different responses of HN activity which had different sensitivities to anaesthesia. However, the characteristic response observed during the swallowing reflex was the most sensitive to increasing depth of anaesthesia.
Anesthesia, Inhalation↗
Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies.
Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement.
Adolescent↗
Chronic mastoiditis causing facial nerve paralysis, hypoglossal nerve paralysis, and abscess in the nasopharynx.
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Abscess↗
[Anatomic study of the hypoglossal nerve in hypoglossal-facial nerve anastomosis].
OBJECTIVE: To determine the optimal position of hypoglossal nerve in hypoglossal-facial nerve anastomosis and the eligibility of hypoglossal-facial nerve anastomosis with the cervical loop. METHODS: The cervical course and adjacent structures of the hypoglossal nerve were observed on 21 adult cadavers. The hypoglossal nerve and facial nerve were taken from 3 fresh specimens, and the number of the fasciculus and the cross-sectional area of the nerve were measured. RESULTS: The facial nerve trunk were monofascicular with a cross-sectional area of 5.1-/+0.2 (range 4.6-5.7) mm(2). The number of the fasciculus and the cross-sectional areas of the nerve trunk and the fasciculus were 1.6-/+0.8 (range 1-4) mm(2) , 7.5-/+0.7 mm(2) (range 6.8-8.0) mm(2), and 4.7-/+0.6 (4.1-5.5) mm(2), respectively, at the proximal segment of the hypoglossal nerve, 3.6-/+0.5 (1-5) mm(2) , 5.6-/+0.5 (4.9-6.1) mm(2) , and 1.6-/+0.4 (0.9-2.2) mm(2) at the distal segment, and 2.4-/+0.8 (1-3) mm(2), 1.1-/+0.7 (0.6-2.2) mm(2), and 0.5-/+0.3 (0.3-1.2) mm(2) at the cervical loop. CONCLUSION: The cervical loop is inadequate for facial nerve anastomosis and the proximal segment is large enough to allow partial harvesting of the hypoglossal nerve for neurotisation of the facial nerve.
Anastomosis, Surgical↗
Cranial nerve XII: the hypoglossal nerve.
The hypoglossal nerve, cranial nerve XII, is the motor supply of the tongue. An understanding of the intracranial and extracranial components is fundamental in the evaluation of hypoglossal pathology. The following discussion of the evaluation of the hypoglossal nerve will involve the embryology, anatomy, clinical basis, and imaging techniques with pathologic correlations.
Humans↗
Trajectory of the hypoglossal nerve in the hypoglossal canal: significance for the transcondylar approach.
A microanatomical study of the hypoglossal canal and its surrounding area was carried out using dry skulls and cadaveric heads to determine the course of the hypoglossal nerve in the hypoglossal canal, especially the significance for the transcondylar approach. The hypoglossal nerve enters the superomedial part of the hypoglossal canal as two bundles, which then change course abruptly to an anterosuperior direction, and unite as one trunk before exiting the canal. The hypoglossal nerve has an oblique course in the canal rather than being located in the center, and exits through the inferolateral part of the canal. A venous plexus surrounds the entire length of the nerve bundles in the canal. The present results suggest that during drilling the occipital condyle toward the hypoglossal canal from behind, the surgeon does not need to be overly concerned even if some bleeding occurs from the posterolateral edge of the hypoglossal canal.
Cadaver↗
[Anatomy of the hypoglossal nerve and the hypoglossal ansa cervicalis].
The hypoglossal nerve is the motor nerve of the tongue and the ansa cervicalis is a motor nerve for the sub-hyoid muscles. The hypoglossal nerve seems to give the innervation of the thyrohyoid although it is a sub-hyoid muscle. Most of axons in the ansa cervicalis arise from the three first cervical nerves. These nerves are in close contact because of the cervical ontogeny of the tongue and the hypoglossal nerve. Nerve impulse in the superior root of the ansa cervicalis runs caudally to rostrally. This is why neurotization techniques using the superior root of the ansa cervicalis produce poor results in the treatment of facial palsy sequelae.
Cranial Fossa, Posterior↗
Bilateral injury to the hypoglossal nerve.
The hypoglossal nerve supplies motor function to the tongue. Two cases of bilateral, post-traumatic injury to the hypoglossal nerve are described. Physical and electromyographic examinations in these cases showed evidence of bilateral injury to the hypoglossal nerve as well as the absence of injury to the other closely associated cranial nerves. (A review of the English literature in the past 20 years shows no cases of isolated bilateral damage to the hypoglossal nerve, although there are several cases of unilateral or combined injury.) The disabilities resulting from hypoglossal nerve palsy and the importance of the tongue in normal swallowing are discussed. Two possible causes of hypoglossal nerve palsy are offered.
Female↗
Aberrant reinnervation following hypoglossal nerve damage.
Hypoglossal nerve damage is a known complication of carotid endarterectomy, occurring in approximately 5% of endarterectomies. The vast majority of these patients recover without functional disability from this injury even if the tongue remains hemiplegic. We report 2 patients who suffered hypoglossal nerve section during neck surgery. Although they were initially mildly symptomatic, they developed increasingly severe dysarthria and dysphagia beginning 4 months after surgery. EMG revealed abnormal coactivation of the genioglossus and styloglossus muscles on the affected side, suggesting aberrant reinnervation. Aberrant reinnervation is a well-known complication of facial nerve injury, but has not been previously recognized in hypoglossal nerve injury. Like the face, the tongue is composed of many muscles that must perform complex movements. Normally, injury to one hypoglossal nerve causes little or no disability, but when aberrant reinnervation occurs, the tongue no longer moves in a coordinated manner, and significant dysarthria ensues.
Aged↗
[Isolated paresis of hypoglossal nerve and combined paresis of hypoglossal nerve and lingual nerve following intubation and direct laryngoscopy].
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Adult↗
Fascicular patterns of the hypoglossal nerve.
Hypoglossal-facial nerve transfer is a standard technique for facial-palsy reconstruction. The fascicular anatomy of the hypoglossal nerve may be important in determining strategies, when attempting to minimize atrophy of the tongue. The present study investigated hypoglossal fascicular anatomy by histomorphometric analysis of 10 human hypoglossal nerves. The nerve demonstrates a monofascicular topography in its proximal third and mid portions, becoming polyfascicular only in its distal third. The mean number of fascicles in the distal portion is 5.0, compared to 1.1 in the proximal and mid portions (p < .01). The mean number of myelinated axons in the hypoglossal nerve is 9200.
Humans↗
Morphometric study of the cervical course of the hypoglossal nerve and its application to hypoglossal facial anastomosis.
The hypoglossal nerve is used classically in salvage of facial paralyses in the absence of spontaneous recovery. A variety of ways of transferring and suturing the hypoglossal nerve to the distal segment of the facial nerve have been reported. In order to determine which mode of reconstruction is the best for neurotisation of the facial nerve, the caliber of the hypoglossal nerve was studied in ten subjects at the level of proximal and distal parts of the trunk and the cervical loop. The fascicular surface area of the cervical branch is inadequate for use. The distal extremity of the hypoglossal nerve has an ideal caliber to be sutured to the facial nerve trunk and the proximal part is large enough to allow partial harvesting of the hypoglossal nerve for neurotisation of the facial nerve.
Cadaver↗
[Importance of the degeneration of afferent components of the hypoglossal nerve on the reflex activity of the nucleus of the hypoglossal nerve in the frog].
The section of frog XII cranial nerve facilitates the reflex activity given by its nucleus. Since this positive effects is not dependent upon any motoneurons degeneration, the hypothesis has been put forward that only the afferent component of the XII nerve is able to modulate the reflex activity by means of PAD effect at the solitarius nucleus. This hypothesis has been tested examining the effect both on the glossopharyngeal reflex response and on the DRR following excision respectively of the dorsal root and of the whole hypoglossal nerve. In preparations with a XII dorsal root transected, electrical stimulation of the homolateral glossopharyngeus nerve evoked a much more intense reflex response than at the intact side. The same effect was evident after the section of the whole nerve.
Animals↗
Branchial cleft cyst manifesting as hypoglossal nerve palsy.
Hypoglossal nerve palsy occurred in 2 patients with infected second branchial arch cleft cyst. This very unusual complication of the congenital anomaly has been related to the mechanical compression of the mass. Histologic features of the perineural coat were also suggestive for this etio-pathogenesis.
Adult↗
Use of an intra-operative nerve stimulator in identifying the hypoglossal nerve.
Previously, the hypoglossal nerve has not undergone intra-operative monitoring during neck operations in which the nerve is at risk. As society becomes increasingly litigious, this may change. This study describes the technique and the microvoltages used in 10 patients for intra-operative stimulation of the hypoglossal nerve with the Magstim nerve stimulator. We confirm that the technique is possible, simple and safe, with minimal disturbance to the patient, anaesthetist and surgeon.
Electric Stimulation↗
Ultrastructural data, with special reference to bouton/glial relationships, from the hypoglossal nucleus after a second axotomy of the hypoglossal nerve.
The left hypoglossal nerve of adult male albino rats was prevented from regenerating to the tongue after a distal axotomy by implanting the proximal stump into normally innervated left sternomasoid muscle. Eighty-four days after implantation, the hypoglossal nerve was transected again and its regeneration to the tongue unimpeded. From 8 to 70 days after this second axotomy the left hypoglossal nuclei were processed for quantitative ultrastructural analysis. The first aim of this study was to compare regeneration success in the hypoglossal nucleus after second axotomy with that accompanying outgrowth of the hypoglossal nerve into denervated sternomastoid muscle. During quantitative analysis a second aim developed, of elucidating bouton/glial relationships. The second axotomy induced loss and return of subsurface cisterns, dispersal and reassembly of Nissl substance, increase and decrease of microglial numbers, slight further loss and partial return of boutons with clear spherical vesicles and symmetrical synapses, slight increase and decrease of boutons with clear flat vesicles and symmetrical synapses, regrowth of retracted dendrites and restoration of their synapses, and gradual diminution of numbers of electron-dense neurones and dendrites. Astrocytes remained hypertrophied throughout. When compared with events in the hypoglossal nucleus accompanying innervation of denervated sternomastoid muscle by the hypoglossal nerve, the results suggest (1) that regeneration of the hypoglossal nerve to its own tongue muscle instead of to a foreign muscle caused no acceleration of recovery in the hypoglossal nucleus, and (2) that the microglial response is dependent on nerve integrity and not on bouton behaviour.
Accessory Nerve↗