Surgical Emergencies
Anthony FT Brown, Michael D Cadogan in Emergency Medicine, 2020
Damage to the following nerves causes specific signs and symptoms: Recurrent laryngeal branch of the vagus: hoarseness and vocal cord paralysis.Accessory nerve: loss of function of trapezius and sternomastoid.Phrenic nerve: loss of diaphragmatic movement, elevated hemidiaphragm on x-ray.Hypoglossal nerve: deviation of the tongue to the affected side.Cervical sympathetic cord: Horner's syndrome, with partial ptosis, a constricted pupil, and decreased sweating on the same side of the face.
Dysarthria associated with hypoglossal nerve palsy and COVID-19
Margaret Walshe, Nick Miller in Clinical Cases in Dysarthria, 2021
This case report describes the management of a motor speech disorder as a consequence of COVID-19. The cause of dysarthria was attributed to CNXII. Lesions of hypoglossal nerve during manoeuvring for oral intubation have been described in several studies (Cinar, Seven, Cinar, & Turgut, 2005; De Luca et al., 2020; Decavel, Petit, & Tatu, 2020; Dziewas & Lüdemann, 2002; Lykoudis & Seretis, 2012; Shah, Barnes, Spiekerman, & Bollag, 2015). Hypoglossal nerve damage may also occur as a result of proning. Decavel et al. describe a patient with COVID-19 who required prolonged prone-position ventilation with lateral flexion of the head (Decavel et al., 2020). In a post-acute care unit, this patient presented with left hypoglossal nerve paralysis and left soft palate weakness along with complete paralysis of the left vocal cord in the abducted position. The authors concluded that the prone-position ventilation could be the main aetiological factor; nevertheless, they did not report about intervention and whether the patient recovered.
Advanced Optical Imaging in the Study of Acute and Chronic Response to Implanted Neural Interfaces
Yu Chen, Babak Kateb in Neurophotonics and Brain Mapping, 2017
Implanted medical devices that interface with the nervous system are currently used to diagnose and treat a wide variety of neurological and psychiatric disorders and impairments. The acceptance of these devices is likely to grow over the next decade to the extent that they are demonstrated to provide benefit to patients who are resistant to treatment by pharmaceutical or other interventions. Neurostimulation devices treat medical conditions such as chronic pain, Parkinson’s disease, essential tremor, epilepsy, hearing loss, and urinary incontinence, among others. There are an estimated 800,000 implanted neurostimulation devices in patients worldwide, and the market share is expected to grow (Medtech Insight 2013). Neural recording devices, which detect neural signals, are currently marketed for epilepsy monitoring and brain mapping. Several medical devices recently approved by the U.S. Food and Drug Administration (FDA) include both stimulation and recording elements. These include a closed-loop system, the NeuroPace Responsive Neurostimulation System for epilepsy, which detects brain electrical signals and provides stimulation to interrupt seizures. Similarly, the Inspire Upper Airway stimulation system to treat sleep apnea detects ventilatory effort and responds with stimulation of the hypoglossal nerve to open the airway. The closed-loop detection/therapy combination of neural sensing and stimulation in a single device platform has the potential to increase the therapeutic potency of future devices.
Tapia syndrome: an unusual complication following posterior cervical spine surgery
Published in British Journal of Neurosurgery, 2019
Adikarige HD Silva, Matthew Bishop, Hari Krovvidi, Declan Costello, Jasmeet Dhir
The hypoglossal nerve is located on the most lateral prominence of the anterior surface of the transverse process of C1 vertebra, crossing the vagus nerve just lateral to the transverse process of C2 vertebra. It also lies postero-medial to the angle of the ramus of the mandible and posterior to the lateral pharyngeal wall. In a neutral head position, the endotracheal tube is usually in the midline. Excessive neck flexion leads to deviation of the endotracheal tube laterally from the midline with pressure, posterior movement of the ramus of the mandible closer to the cervical spine and therefore, potentiates entrapment and compression of the two nerves between endotracheal tube and pharyngeal wall, mandibular ramus and the transverse process of the C2 cervical vertebra. In our case, surgical time was not excessively prolonged, but there was a possibility of hyper-flexion.
Effects of Peak Inspiratory Pressure-Guided Setting of Intracuff Pressure for Laryngeal Mask Airway Supreme™ Use during Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Published in Journal of Investigative Surgery, 2021
Mao-Hua Wang, Dong-Sheng Zhang, Wei Zhou, Shun-Ping Tian, Tian-Qi Zhou, Wei Sui, Zhuan Zhang
Blood was seen on the LMA at the time of its removal in two patients in the PIP group and in three patients in the control group (P > 0.05). There were no instances of bucking, regurgitation, aspiration, or laryngospasm in either group. The incidences of sore throat and dysphagia in the PACU and at 24 h postoperatively were significantly lower in the PIP group than in the control group (95% CI: 0.07 to 0.36, P = 0.005, sore throat in PACU; 95% CI: 0.08 to 0.35, P = 0.003, sore throat at 24 h postoperatively; 95% CI: 0.08 to 0.38, P = 0.003, dysphagia in PACU; 95% CI: 0.10 to 0.37, P = 0.001, dysphagia at 24 h postoperatively). The incidences of pharyngeal hematoma and dysphonia were lower in the PIP group than in the control group, although the difference was not significant (95% CI: −0.03 to 0.19, P = 0.144, pharyngeal hematoma in PACU and at 24 h postoperatively; 95% CI: −0.04 to 0.11, P = 0.404, dysphagia in PACU and at 24 h postoperatively). No cases of nerve damage, such as recurrent laryngeal nerve paralysis, hypoglossal nerve paralysis, and lingual nerve paralysis, occurred in either group (Table 4).
A rare cause of unilateral hypoglossal nerve palsy: case report of intraneural ganglion cyst of the hypoglossal nerve and review of the literature
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Jeremie D. Oliver, Antonio J. Forte
Ganglion cysts causing hypoglossal compression are rare. They are typically found in peripheral nerves near tendon sheaths, often near the carpal tunnel, or in the knee region near the fibular head [1–3]. Cranial nerves are rarely affected by intraneural ganglion cysts [3]. These cysts can present clinically by causing compression of the adjacent nerve fascicles, resulting in pain, paresthaesia, weakness, muscle denervation, and atrophy [1]. Significant clinical findings to be expected from an intraneural ganglion cyst of the hypoglossal nerve include unilateral tongue deviation and atrophy on the affected side, as well as potentially slurred speech or compression of nerves of the jugular foramen [4–7]. The present literature documents only four cases being reported [4–7]. We report an extremely rare case of a patient with a hypoglossal cystic lesion. The aim of this report is to present our surgical approach to treatment and to compare our findings with previous reported cases of unilateral hypoglossal nerve palsy, highlighting the importance of an intraneural (or extraneural) ganglion cyst in the differential diagnosis of such.
Related Knowledge Centers
- Brainstem
- Hypoglossal Canal
- Motor Nerve
- Medulla Oblongata
- Tongue
- Vagus Nerve
- Cranial Nerves
- Palatoglossus Muscle
- Hypoglossal Nucleus
- Als