Pdf on jul 31, 2016, chang jae kim and others published cranial nerve xii hypoglossal nerve palsy after arthroscopic shoulder surgery under general anesthesia combined with sonoguided. To test the function of the hypoglossal nerve, a person is asked to poke out hisher tongue. Hypoglossal definition of hypoglossal by medical dictionary. Five adult cadaver heads providing 10 facial nerves cranial nerve. Note the proximity of the cisternal portion of the hypoglossal nerve to the vertebral artery. Unilateral hypoglossal neurapraxia following endotracheal. Reason he wont be able to speak is that the hypoglossal nerve controls the tongue, one on each side. This symptom is the key to the diagnosis of a hypoglossal nerve injury. Clinically relevant anatomy of high anterior cervical approa. The hypoglossal vertebral entrapment syndrome 1 occurs as the hypoglossal rootlets converge directly over the distorted vessel with resultant mechanical compression and direct nerve ischemia. Surgical anatomy of hypoglossal nerve as a guide for important head and neck surgeries. A rare presentation of presumed pyogenic meningitis. I had a hip surgery and woke up with this hypoglossal nerve injury. Therefore, deficits in the oral phase may suggest damage to the hypoglossal nerve.
Injury to the hypoglossal nerve is a recognised complication after soft tissue surgery in the upper part of the anterior aspect of the neck, e. Other articles where hypoglossal nerve is discussed. Trigeminal nerve anatomy cranial nerve 5 course and distribution duration. The hypoglossal nerve is the twelfth cranial nerve and controls movements of the tongue. The nerve emerges from the medulla laterally, between the pyramid and the olive as a number of rootlets. Hypoglossal nerve definition of hypoglossal nerve by. The hypoglossal nerve is the twelfth cranial nerve, and innervates all the extrinsic and intrinsic muscles of the tongue, except for the palatoglossus which is innervated by the vagus nerve. The anterior approach is a common approach to the cervical spine. Indeed, hn partly derives its blood supply from vertebral branches. I kind of know where the hypoglossal nerve is located when i look at the diagram, but id like to know how far is the nerve from the skin and where is the closest area to the skin before and right after its branching. Jeanpierre barral, alain croibier, in manual therapy for the cranial nerves, 2009. We report the case of a 35yearold woman with tuberculosis of c23. Isolated peripheral hypoglossal palsy caused by a kinking of the left vertebral artery hypoglossal vertebral entrapment syndrome. The hypoglossal nerve plays an important role in the oral phase.
Hypoglossal nerve disorders merck manuals consumer version. The segmental approach to the anatomy and pathologic conditions of the hypoglossal nerve is used to clarify the differential diagnosis. The hypoglossal nerve is the motor supply to the tongue muscles and may be damaged in its intracranial or extracranial course. Neurology hypoglossal nerve cranial nerve xii youtube. If there is a loss of function on one side unilateral paralysis, the tongue will point toward the affected side, due to unopposed action of the genioglossus muscle which pulls the tongue forward on the side of the tongue that is usually innervated.
Hypoglossal nerve palsy medigoo health medical tests. The hypoglossal canal is formed during the embryological stage of development in mammals, sometimes leading to the presence of more than two canals as the occipital bone is formed. Hypoglossalvertebral entrapment syndrome neurology. The hypoglossal nerve supplies motor fibres to all muscles of the tongue, except the. The hypoglossal nerve is the twelfth paired cranial nerve. The hypoglossal nerve supplies all the muscles of the tongue including the intrinsic muscles, and also the geniohyoid muscle. Nerve transfers are indicated when the main trunk of the facial nerve is damaged or unavailable but the distal nerve branches and facial muscles remain viable. Hypoglossal nerve palsy hnp is an uncommon cranial nerve palsy comparing to other commoner cranial nerves such as 3rd, 6th, and 7th cranial nerves 4. Explaining all of them at once would mean too much complex information and facts, so in this particular article, we will be focused on the anatomy and the clinical importance of the last, but certainly not the least, 12th cranial nerve called the hypoglossal nerve cn xii. Pdf physiotherapy management of peripheral unilateral isolated. These are 1 the oculomotor nucleus, the source of general somatic efferent fibres to superior, medial, and inferior recti muscles, to the inferior oblique muscle, and to the levator palpebrae superious muscle, and 2 the edingerwestphal nucleus, which projects general visceral efferent preganglionic fibres to the ciliary. Pdf hypoglossal nerve injury as a complication of anterior. The hypoglossal nerve is used for daily functions most people take for granted, like eating and speech. In order to get clear margins theyll have to remove the nerve and for assurance they want to remove everything else.
Pdf cranial nerve xii hypoglossal nerve palsy after. Hypoglossal nerve an overview sciencedirect topics. May 11, 2020 after this, the hypoglossal nerve passes over the superficial side of the hyoglossus muscle, and passes above the greater horn of the hyoid bone. The oculomotor nerve arises from two nuclei in the rostral midbrain. The full text of this article is available in pdf format. The nerve arises from the hypoglossal nucleus in the medulla as a number of small rootlets, passes through the hypoglossal canal and down through the neck, and. Along with cn ix, it provides part of the sensory and motor innervation of the pharynx. Anatomy of the head and neck goals of comprehensive. Cn vii and 10 hypoglossal nerves cn xii were fixed in formalin. Much of the operative morbidity in high cervical region is related to neurovascular injury leading to dysphagia, dysphonia, impaired highpitch phonation, and impaired cough reflex. Isolated hypoglossal nerve palsy hnp, or neurapraxia, a rare postoperative complication. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Nov 17, 2015 this video is part of a playlist of short videos which are intended to combine multiple choice questions answering experience with an improved understanding of anatomy. Is there any video or schema showing the location of the hypoglossal nerve relative to skin and not the skeleton. Hypoglossal nerve injury as a complication of anterior. The hypoglossal nerve is found beneath the tongue as the word roots imply. Anatomy, anatomical variations comorbidities and clinical significance the purpose of this study is a. In the open medulla, it is visible as what is known as the hypoglossal trigone, a raised area medial to the vagal trigone protruding slightly into the fourth ventricle. Scullys medical problems in dentistry seventh edition, 2014. In contrast, spinal nerves emerge from segments of the spinal cord. Hypoglossal rootlets project ventrally through the medulla to emerge in the preolivary sulcus. Ninja nerds, in this video we discuss the origin, course, and the structures supplied by the hypoglossal nerve. This video is part of a playlist of short videos which are intended to combine multiple choice questions answering experience with an improved understanding of anatomy. The nerve has a purely somatic motor function, innervating all the extrinsic and intrinsic muscles of the tongue except the palatoglossus, innervated by vagus nerve. Bilateral hypoglossal nerve palsy due to brainstem infarction. Department of orthopaedic surgery, hamamatsu university school of medicine, hamamatsu, japan.
These join to form two roots, and passing anteriorly. Souza a mamatha hosapatna b kantharaj seva naik b antony sylvan d. The slight bulge into the fourth ventricle is termed the hypoglossal eminence. Surgical anatomy of hypoglossal nerve as a guide for. If there is hypoglossal nerve palsy, the tongue will point toward the palsy side. A 66yearold man presented to our hospital with dysphagia and neck pain. The 12th cranial nerve makes it possible to move the tongue muscles. After this, the hypoglossal nerve passes over the superficial side of the hyoglossus muscle, and passes above the greater horn of the hyoid bone.
The most common are metastatic carcinomas, chordomas, nasopharyngeal carcinomas, gliomas, and acoustic neuromas. However, this complication has been rarely reported following surgery of the upper cervical spine. It receives fibers from both cerebral hemispheres, with one exception. From the hypoglossal nucleus in the medulla oblongata, general somatic efferent fibres exit the cranial cavity through the hypoglossal canal and enter the neck in close proximity. The path of the nerve starts in the hypoglossal nucleus of the brainstem, which is located near the midline. Disorders of the 12th cranial nerve hypoglossal nerve cause weakness or wasting atrophy of the tongue on the affected side. Anatomy of the skull supraorbital foramensupraorbital nerve and vessels optic canaloptic nerve, ophthalmic artery superior orbital fissure nasociliary, frontal, and lacrimal branches of v1, occulomotor nerve, trochlear nerve, abducens nerve, superior and inferior ophthalmic veins inferior orbital fissurev2, zygomatic nerve, infraorbital vessels. It eventually comes up to the floor of the mouth and connects with the muscles of your tongue. Isolated hypoglossal palsy caused by synovial cyst 43. Vertebrobasilar dolichoectasia with hypoglossal nerve palsy 40. This segment of the pathway, from the hyoglossus muscle and the greater horn of the hyoid bone, is the part of the nerve that forms the superior edge of the pirogov triangle also known as the pirogoff triangle, and it is covered by the submandibular. A detailed understanding of the anatomy of the hypoglossal nerve in relation to various anatomical landmarks and surrounding structures is important to reduce procedural complications and the risk of nerve damage.
Description and physiology the hypoglossal nerve is chiefly a motor nerve responsible for innervating the muscles of the tongue. Study of this area aids in the diagnosis of a variety of tumors found at the base of the skull, including. Hypoglossal nerve palsy is not common in literature, especially its physiotherapy assessment and management. Pdf on jan 1, 2014, stanley m maduagwu and others published. Cranial nerves relay information between the brain and parts of the body, primarily to and from regions of the head and neck.
The hypoglossal nerve innervates certain muscles that control movement of the tongue. Hypoglossal nerve palsy as a complication of an anterior approach. Physiotherapy management of peripheral unilateral isolated. Cisternal hypoglossal schwannoma with tongue atrophy 42. Delayed hypoglossal nerve palsy following occipital condyle fracture. Hypoglossal nerve palsy as a complication of an anterior. When it is damaged, or functions improperly, the result is loss of tongue muscle function. Nov 11, 2017 hypoglossal nucleus the hypoglossal nucleus is a cranial nerve nucleus, and it extends the length of the medulla, and being a motor nucleus, is close to the midline. Hypoglossal nerve palsy after airway management for general. Hypoglossal nerve palsy hnp is a potential cause of dysphagia. When it comes to the innervation of the head and neck, we know its all about the cranial nerves. The nerve arises from the hypoglossal nucleus in the medulla as a number of small rootlets, passes through the. It allows control of the tongue for such things as mixing food you have eaten into a ball.
The hypoglossal nerve then runs between the carotid artery and the jugular vein, down into the neck, where it crosses the sternocleidomastoid muscle and runs along the mylohyoid muscle. Extracranial at exit deeply placed than ijv, ica,9th. The hypoglossal nerve runs under the tongue and controls tongue movements. Hypoglossal nerve transfer for facial paralysis surgery. Jan 17, 2011 hypoglossal nerve injury from tube inhibation chickadee1955 ive been searching all over online for someone else that has gone through this. Hypoglossal nerve definition of hypoglossal nerve by the. The nucleus, called the hypoglossal nucleus, is located in the medulla beneath the lower part of the fourth ventricle. This cranial nerve is also responsible for the articulation of speech and the act of swallowing. The lower cranial nerves innervate the pharynx and larynx by the. Cranial nerves are the nerves that emerge directly from the brain including the brainstem. The hypoglossal nerve hn may be damaged during neck surgeries. The hypoglossal nerve is the twelfth and last cranial nerve and supplies the tongue with motor control. Hypoglossal nerve palsy as a cause of severe dysphagia along. These techniques are best suited to cases of facial paralysis less than 2 years in duration.
To look at the descending branch of the hypoglossal nerve, well go further down the neck. Hypoglossal nerve disorders brain, spinal cord, and nerve. Hypoglossal nerve 12th cranial nerve detailed anatomy. Note that palatoglossus, one of the extrinsic tongue muscles, is innervated by the vagus nerve.
848 1134 561 682 1424 1118 1197 110 893 907 280 1032 189 841 194 640 858 129 1093 600 112 899 982 1272 1647 734 1484 526 461 833 979 1164 201 1036 85 296 414