Case Of Hypoglossal Nerve Palsy Research Articles

Case Report: Resolution of Hypoglossal Nerve Palsy Following Aspiration of a Branchial Cyst

Abstract Cranial nerve palsies caused directly by branchial cysts is a rare entity. We report a case of hypoglossal nerve palsy in a 47-year-old female with a right anterior neck mass presenting with symptoms of speech disturbances, altered tongue sensation and deviation on protrusion. An ultrasound scan showed a cystic lesion highly suspicious for a branchial cyst, which was confirmed with a head and neck MRI. An ultrasound guided aspiration of the cyst resulted in resolution of the nerve palsy in our patient. There have been cases reported in literature whereby the nerve palsies resolve following surgical excision of the branchial cyst.

Carotid body Tumour with Hypoglossal Nerve Palsy- A Case Report

Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of the right side involving the right hypoglossal nerve with MRI appearance and pathological features. The objective is to present a case of Hypoglossal nerve palsy due to carotid body tumour involving the right carotid artery bifurcation.
 Method: A 18-year old male presented with a welldefined swelling of his right neck, increasing hoarseness, and left ward tongue deviation on protrusion present for two years CT neck and MRI were done. The tumour was identified and the patient underwent surgery. His Histopathology report commented it to be carotid body tumour.
 Result: The patient showed significant improvement after surgery. His tongue deviation improved and his hoarseness of voice had been begun to improve.
 Conclusion: Carotid body tumours are benign lesion mimicking other pathology. High level of suspicision, imaging and careful resection is important for avoiding complications.
 Bangladesh Heart Journal 2019; 34(1) : 68-72

Hypoglossal Nerve Palsy due to Occipito-Cervical Kyphosis: A Case Report

Hypoglossal nerve palsy (HNP) is a potential cause of dysphagia. There have been few reports presenting with HNP associated with spinal diseases. Here, we report a case of HNP caused by postoperative upper cervical deformity. A 66-year-old man presented to our hospital with dysphasia and neck pain. One year prior to his first visit, he had been diagnosed with upper cervical tuberculosis and had undergone posterior C1-C2 fixation. These symptoms, however, further worsened nine months after the initial surgery. The physical examination led to the diagnosis of HNP. Radiographic examination revealed that the O-C kyphosis had been exacerbated and that this deformity was likely the primary cause of HNP. To restore the swallowing function, O-C fusion surgery was performed. Postoperatively, the patient showed immediate improvement of dysphasia with gradual recovery of hypoglossal nerve function. Our results indicate that the kyphosis in O-C junction would be a potential cause of HNP.

Influence of prevertebral soft tissue swelling on dysphagia after anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage.

Background:Postoperative oropharyngeal complications such as dysphagia after anterior cervical spine surgery are some of the least discussed surgery-related complications. The purpose of this retrospective study is to investigate the incidence and possible risk factors for 30-day postoperative dysphagia after anterior cervical discectomy and fusion (ACDF).Materials and Methods:This study included 152 consecutive patients who underwent 1- or 2-level ACDF using a rectangular titanium stand-alone cage in our institutes. Surgery-related dysphagia early after surgery was analyzed based on hospital charts. Radiological evaluation of prevertebral soft tissue swelling (PSTS) was performed by comparing plain lateral radiographs of the cervical spine before surgery with those after surgery. The percentage of PSTS (%PSTS) was defined by retropharyngeal soft tissue diameter divided by vertebral diameter. Positive %PSTS was determined when %PSTS exceeded its mean + 2 standard deviations.Results:Twelve patients (7.9%) demonstrated prolonged symptoms of dysphagia within 30-day postoperatively. All patients eventually demonstrated satisfactory or acceptable recovery late after surgery, except one case of hypoglossal nerve palsy. %PSTS was significantly highest early after surgery and returned to presurgical levels within 30 days after surgery. Statistical analysis suggested that the positive %PSTS at C3 or C4 level early after surgery was significantly associated with the occurrence of postoperative dysphagia.Conclusions:Although the possible reasons for postoperative dysphagia may not only be multifactorial but also be highly surgeon-dependent, such a complication is still underestimated and needs to be carefully resolved. %PSTS appeared to be easy and reliable index to judge the possible risk of postoperative dysphagia.

Isolated hypoglossal nerve palsy posttonsillectomy

Hypoglossal nerve palsy posttonsillectomy is a rare complication that can occur following orotracheal intubation for general anaesthesia for surgical procedures. We present a case of hypoglossal nerve palsy occurring in a 38-year-old female medical practitioner. Possible mechanisms of this complication are discussed.

Hypoglossal nerve palsy after airway management for general anesthesia: an analysis of 69 patients.

Isolated hypoglossal nerve palsy (HNP), or neurapraxia, a rare postoperative complication after airway management, causes ipsilateral tongue deviation, dysarthria, and dysphagia. We reviewed the pathophysiological causes of hypoglossal nerve injury and discuss the associated clinical and procedural characteristics of affected patients. Furthermore, we identified procedural factors potentially affecting HNP recovery duration and propose several measures that may reduce the risk of HNP. While HNP can occur after a variety of surgeries, most cases in the literature were reported after orthopedic and otolaryngology operations, typically in males. The diagnosis is frequently missed by the anesthesia care team in the recovery room due to the delayed symptomatic onset and often requires neurology and otolaryngology evaluations to exclude serious etiologies. Signs and symptoms are self-limited, with resolution occurring within 2 months in 50% of patients, and 80% resolving within 4 months. Currently, there are no specific preventive or therapeutic recommendations. We found 69 cases of HNP after procedural airway management reported in the literature from 1926 to 2013.

Hypoglossal nerve palsy caused by an aneurysm of the external carotid artery

We report a rare case of hypoglossal nerve palsy in a 74-year-old woman, which was caused by an aneurysm of the external carotid artery. Fluoroscopic-guided embolisation with micro-coils was performed with complete resolution of symptoms.

A Case of Hypoglossal Nerve Palsy after Tonsillectomy

Tonsillectomy is a common procedure in the ENT department but unusual complications related to nerve injury might be associated with the surgery. We report a case of permanent hypoglossal nerve palsy following tonsillectomy in a 33-year-old female patient. The findings from the neu-rologic examination were unremarkable except for tongue deviation to the left, hemiatrophy of the tongue and associated dysarthria. Forceful pressure and stretch of hypoglossal nerve during surgery can explain the cause of injury. To avoid nerve compression, intermittent release of the mouth gag and avoidance of neck hyperextension are suggested especially when long operation time would be expected. Although rare, having knowledge of the existence of hypoglossal nerve injury complicating tonsillectomy is important when counseling patients.

舌筋の線維束性れん縮により椎骨動脈りゅうが発見された片側性舌下神経麻ひの１例

Hypoglossal nerve palsy (HNP) with fasciculation of the tongue is unusual, but occasionally occurs as the initial or solitary sign of an intracranial lesion. We report a case of HNP caused by a vertebral artery aneurysm which was found due to fasciculation of the tongue. A 40-year-old man was referred to Iizuka Hospital because of lingual deviation and slight dysarthria. Intraoral examination showed hemiatrophy in the right side of the tongue with fasciculation and deviation towards the right side on protrusion. There were no other clinically significant neurological findings. Magnetic resonance imaging and an angiographic examination revealed a vertebral artery aneurysm, which was treated by proximal arterial occlusion of the vertebral artery to prevent rupture and subsequent subarachnoid hemorrhage. The postoperative course was favorable, without any serious sequelae. This case demonstrates the importance of investigating the possibility of intracranial lesions in patients who have HNP with fasciculation of the tongue.

후두 미세수술 후 발생한 설하신경 마비 1예

Hypoglossal nerve injury is a recognized but rare complication of laryngomicrosurgery. We have recently encountered a case of hypoglossal nerve palsy as a complication laryngomicrosurgery. We would like to report a case of unilateral hypoglossal nerve paralysis following laryngomicrosurgery and discuss theory concerning the pathophysiological mechanisms of nerve damage as described in the literature. (J Clinical Otolaryngol 2004;15:127-129)

Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports

Blankenship LD, Basford JR, Strommen JA, Andersen RJ. Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports. Arch Phys Med Rehabil 2002;83:269-72. Rheumatoid arthritis (RA) involvement of the cervical spine is a well-known but perhaps underappreciated phenomenon. Neurologic complications of this involvement include pain, myelopathy, and cranial nerve (CN) palsies. However, hypoglossal nerve palsy (CN XII) is rarely diagnosed. Mechanical nerve injury, either from vertical odontoid subluxation or pannus formation, is the suspected mechanism. We present 2 cases of hypoglossal nerve palsy attributed to cervical spine involvement of RA and 1 case of postoperative tongue weakness after cervical fusion in a patient with long-standing RA. These cases show a potentially devastating complication of RA that may be underdiagnosed. Therapy involving the cervical spine must be prescribed with caution in this patient population. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

A rare case of hypoglossal nerve palsy complicating a head injury.

Hypoglossal nerve palsy (HNP) may follow fracture of the base of the skull. Of the various aetiologies described, trauma is one of the least frequent. HNP can easily be missed...