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1.
J Clin Neurosci. 2019 Feb;60:128-131. doi: 10.1016/j.jocn.2018.11.020. Epub 2018 Nov 13.

Effects of various lengths of hypoglossal nerve resection on motoneuron survival.

Author information

1
Department of Anatomy, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
2
Department of Anatomy, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. Electronic address: nanae@shinshu-u.ac.jp.

Abstract

We employed stereological analyses for whole quantification of hypoglossal (XII) motoneurons in adult rats that received varying degrees of resection of the XII nerve. Various lengths of nerve gaps (0.0-13.3 mm) were made at the main trunk of the unilateral XII nerve, and the total number of XII neurons on the injured and uninjured sides was counted 12 weeks after nerve resection. The stereologically estimated total number of XII neurons decreased after various lengths of nerve resection, and survival rates ranged from 34.4% to 87.1%. Statistically significant negative correlations were observed between increasing length of the resected nerve and decreasing XII neuron survival. It was concluded that the total number of XII neurons decreased after nerve resection and that survival rates of XII neurons were related to distances between resected nerve stamps.

KEYWORDS:

Adult rats; Hypoglossal nerve; Nerve resection; Neuron number; Neuronal cell death; Stereology

PMID:
30446373
DOI:
10.1016/j.jocn.2018.11.020
[Indexed for MEDLINE]
Icon for Elsevier Science
2.
Ugeskr Laeger. 2018 Jul 2;180(27). pii: V11170844.

[Vagus and hypoglossus palsy after nasotracheal intubation and throat packing].

[Article in Danish]

Author information

1
troels.schmidt@rsyd.dk.

Abstract

Ipsilateral extracranial palsy of the hypoglossus and vagus nerve is a rare complication of intubation. This is a case report of a 50-year-old male with unilateral palsy of the hypoglossus and vagus nerve after reoperation for a mandibular fracture. The patient underwent logopaedic treatment, and ten months after the operation there was significant but not complete remission of symptoms. Videostroboscopy revealed near-normalisation of vocal cord movement.

PMID:
29984697
[Indexed for MEDLINE]
Icon for Danish Medical Association
3.
Anesth Prog. 2018 Summer;65(2):129-130. doi: 10.2344/anpr-65-04-06.

Tapia's Syndrome.

Author information

1
Mid Essex Hospitals Trust, Chelmsford, United Kingdom, and.
2
Princess of Wales Hospital, Bridgend, United Kingdom.

Abstract

More than 100,000 general anesthetic procedures are conducted in United Kingdom every year for dental interventions, according to large survey of the National Health Services. 1 The risk of mortality has reduced considerably in the past few decades because of the use of safe and effective techniques. However, adverse effects still exist and are dependent on patient, environmental, and operator factors. We present an uncommon complication of intubation that merits due awareness.

KEYWORDS:

Dysphonia; Hoarseness; Hypoglossal nerve palsy; Tapia's; Vagus nerve palsy

PMID:
29952646
PMCID:
PMC6022793
DOI:
10.2344/anpr-65-04-06
[Indexed for MEDLINE]
Free PMC Article
Icon for Allen Press, Inc. Icon for PubMed Central
4.
Medicine (Baltimore). 2018 Jun;97(22):e10980. doi: 10.1097/MD.0000000000010980.

A case report of Tapia's syndrome after mastectomy and breast reconstruction under general anesthesia.

Author information

1
Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University Hospital.
2
Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University.
3
Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.

Abstract

RATIONALE:

Tapia's syndrome is a rare and potentially anesthesia-related complication that may cause considerable distress to the patient. Here we describe a case of unilateral Tapia's syndrome in a patient undergoing a skin sparing mastectomy and immediate breast reconstruction which, to the best of our knowledge, has not been reported in the literature.

PATIENT CONCERNS:

A 41-years old female underwent right skin sparing total mastectomy and breast reconstruction with latissimus dorsi flap under general anesthesia. On the first postoperative day, she complained left sided tongue deviation, subtle hoarseness and swallowing difficulty.

DIAGNOSIS:

Tapia's syndrome, a combined paralysis of ipsilateral vocal cord and tongue due to injury to the hypoglossal and recurrent laryngeal nerves, in this case, resulting potentially from head and neck position changes INTERVENTIONS:: The patient was closely observed with the administration of empirical prednisolone 5 mg/day for 3 weeks.

OUTCOMES:

One month after the surgery, functions of the tongue and vocal cord were completely resolved.

LESSONS:

Particular attention should be paid to the maintenance of adequate cuff pressure, proper position of endotracheal tube and correct neck positioning, especially when procedures taking a long operation time under endotracheal anesthesia and requiring frequent position changes of the patient's head and neck.

PMID:
29851851
PMCID:
PMC6392620
DOI:
10.1097/MD.0000000000010980
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
5.
Cell Death Dis. 2018 May 1;9(5):531. doi: 10.1038/s41419-018-0553-6.

SIRT1 activation with neuroheal is neuroprotective but SIRT2 inhibition with AK7 is detrimental for disconnected motoneurons.

Author information

1
Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
2
Chromatin Biology Laboratory, Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L´Hospitalet de Llobregat, Barcelona, Spain.
3
Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, 41012, Spain.
4
Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Caty.Casas@uab.cat.

Abstract

Sirtuin 1 (SIRT1) activity is neuroprotective, and we have recently demonstrated its role in the retrograde degenerative process in motoneurons (MNs) in the spinal cord of rats after peripheral nerve root avulsion (RA) injury. SIRT2 has been suggested to exert effects opposite those of SIRT1; however, its roles in neurodegeneration and neuron response after nerve injury remain unclear. Here we compared the neuroprotective potentials of SIRT1 activation and SIRT2 inhibition in a mouse model of hypoglossal nerve axotomy. This injury induced a reduction of around half MN population within the hypoglossal nucleus by a non-apoptotic neurodegenerative process triggered by endoplasmic reticulum (ER) stress that resulted in activation of the unfolded protein response mediated by IRE1α and XBP1 by 21 days post injury. Both SIRT1 activation with NeuroHeal and SIRT2 inhibition with AK7 protected NSC-34 motor neuron-like cells against ER stress in vitro. In agreement with the in vitro results, NeuroHeal treatment or SIRT1 overexpression was neuroprotective of axotomized hypoglossal MNs in a transgenic mouse model. In contrast, AK7 treatment or SIRT2 genetic depletion in mice inhibited damaged MN survival. To resolve the in vitro/in vivo discrepancies, we used an organotypic spinal cord culture system that preserves glial cells. In this system, AK7 treatment of ER-stressed organotypic cultures was detrimental for MNs and increased microglial nuclear factor-κB and the consequent transcription of cytotoxic pro-inflammatory factors similarly. The results highlight the importance of glial cells in determining the neuroprotective impact of any treatment.

PMID:
29748539
PMCID:
PMC5945655
DOI:
10.1038/s41419-018-0553-6
[Indexed for MEDLINE]
Free PMC Article
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6.
Pediatr Neurosurg. 2018;53(4):282-285. doi: 10.1159/000487512. Epub 2018 Mar 22.

Occipital Condyle Fracture Extending to the Inferior Part of the Clivus.

Abstract

Although rarely reported in the literature, serious occipital and condylar fractures have been diagnosed more often with the widespread use of computed cranial tomography in traumas. In this paper, a 16-year-old female with a left occipital fracture extending from the left occipital condyle anterior of the hypoglossal canal to the inferior part of the clivus is presented. The fracture which had caused a neurological deficit was cured with conservative treatment. For delayed hypoglossal nerve paralysis due to swelling within the canal, methylprednisolone was started, and a complete cure was attained in about 10 days. Traumatic damage of bony structures of the condyle and clivus at the junction of many vital nerves, vessels, and ligaments may lead to traumatic deficit and death.

KEYWORDS:

Clivus fracture; Hypoglossal canal; Occipital condyle

PMID:
29566386
DOI:
10.1159/000487512
[Indexed for MEDLINE]
Icon for S. Karger AG, Basel, Switzerland
7.
Ann R Coll Surg Engl. 2018 Feb;100(2):125-128. doi: 10.1308/rcsann.2017.0176. Epub 2017 Nov 28.

The significance of the pharyngeal veins during carotid endarterectomy: description of an anatomical triangle.

Author information

1
Huddersfield Royal Infirmary , Lindley, Huddersfield , UK.
2
Royal College of Surgeons of England , London , UK.

Abstract

Injuries to the hypoglossal and vagus nerves are the most commonly reported injuries during carotid endarterectomy. While unilateral single nerve injury is usually well tolerated, bilateral or combined nerve injuries can pose a serious threat to life. This study aims to increase awareness of the inferior pharyngeal vein, which usually passes posterior to the internal carotid artery but sometimes crosses anterior to it. Injury to either or both hypoglossal and vagus nerves can occur during control of unexpected haemorrhage from the torn and retracted edges of the inferior pharyngeal vein. We recommend careful ligation and division of this vein. In addition, we observed in 9 (17.3%) of the 52 operations that the pharyngeal vein formed a triangle with the vagus and hypoglossal nerves when it passes anterior to the internal carotid artery.

KEYWORDS:

Carotid endarterectomy; Pharyngeal vein; Triangle

PMID:
29181992
PMCID:
PMC5838694
DOI:
10.1308/rcsann.2017.0176
[Indexed for MEDLINE]
Free PMC Article
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8.
Oper Neurosurg (Hagerstown). 2018 Jun 1;14(6):697-704. doi: 10.1093/ons/opx209.

Development of a Whole-Task Simulator for Carotid Endarterectomy.

Author information

1
School of Medicine and Dentistry, University of Rochester, Rochester, New York.
2
Division of Vascular Surgery, Strong Memorial Hospital, University of Rochester, Rochester New York.
3
Department of Urology, Strong Memorial Hospital, University of Rochester, Rochester, New York.
4
Department of Neurosurgery, Strong Memorial Hospital, University of Rochester, Rochester, New York.

Abstract

BACKGROUND:

Surgical education relies on operative exposure with live patients. Carotid endarterectomy (CEA) demands an experienced surgeon with a very low complication rate. The high-risk nature of this procedure and the decline in number of CEAs performed annually has created a gap in residency training.

OBJECTIVE:

To develop a high-fidelity whole-task simulation for CEA that demonstrates content, construct, and face validity.

METHODS:

Anatomically accurate models of the human neck were created using multilayered poly-vinyl alcohol hydrogels. Graded polymerization of the hydrogel was achieved by inducing crosslinks during freeze/thaw cycles, stiffening the simulated tissues to achieve realistic tactile properties. Venous bleeding was simulated using pressure bags and a ventricular assistive device created pulsatile flow in the carotid. Ten surgeons performed the simulation under operating room conditions, and metrics were compared among experience levels to determine construct validity. Participants completed surveys about realism and usefulness to evaluate face validity.

RESULTS:

A significant difference was found in operative measures between attending and resident physicians. The mean operative time for the expert group was 63.6 min vs 138.8 for the resident group (P = .002). There was a difference in mean internal carotid artery clamp time of 43.4 vs 83.2 min (P = .04). There were only 2 hypoglossal nerve injuries, both in the resident group (P = .009).

CONCLUSION:

The whole-task CEA simulator is a realistic, inexpensive model that offers comprehensive training and allows residents to master skills prior to operating on live patients. Overall, the model demonstrated face and construct validity among neurosurgery and vascular surgeons.

PMID:
29029228
DOI:
10.1093/ons/opx209
[Indexed for MEDLINE]
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9.
J Cell Mol Med. 2017 Dec;21(12):3752-3760. doi: 10.1111/jcmm.13284. Epub 2017 Aug 2.

Decreased hippocampal brain-derived neurotrophic factor and impaired cognitive function by hypoglossal nerve transection in rats.

Author information

1
Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University, School of Dentistry, Seoul, Korea.
2
Department of Brain Science, Daegu Gyeongbuk Institute of Science & Technology, Dae Gu, Korea.
3
Department of Physiology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.

Abstract

The hypoglossal nerve controls tongue movements, and damages of it result in difficulty in mastication and food intake. Mastication has been reported to maintain hippocampus-dependent cognitive function. This study was conducted to examine the effect of tongue motor loss on the hippocampus-dependent cognitive function and its underlying mechanism. Male Sprague Dawley rats were subjected to the initial training of Morris water maze task before or after the bilateral transection of hypoglossal nerves (Hx). When the initial training was given before the surgery, the target quadrant dwelling time during the probe test performed at a week after the surgery was significantly reduced in Hx rats relative to sham-operated controls. When the initial training was given after the surgery, Hx affected the initial and reversal trainings and probe tests. Brain-derived neurotrophic factor (BDNF) expression, cell numbers and long-term potentiation (LTP) were examined in the hippocampus on the 10th day, and BrdU and doublecortin staining on the 14th day, after the surgery. Hx decreased the hippocampal BDNF and cells in the CA1/CA3 regions and impaired LTP. BrdU and doublecortin staining was decreased in the dentate gyrus of Hx rats. Results suggest that tongue motor loss impairs hippocampus-dependent cognitive function, and decreased BDNF expression in the hippocampus may be implicated in its underlying molecular mechanism in relation with decreased neurogenesis/proliferation and impaired LTP.

KEYWORDS:

hippocampus; learning and memory; tongue

PMID:
28767193
PMCID:
PMC5706565
DOI:
10.1111/jcmm.13284
[Indexed for MEDLINE]
Free PMC Article
Icon for Wiley Icon for PubMed Central
10.
J Prosthodont Res. 2017 Oct;61(4):460-463. doi: 10.1016/j.jpor.2017.01.006. Epub 2017 Feb 21.

Effect of palatal augmentation prosthesis on pharyngeal manometric pressure in a patient with functional dysphagia: A case report.

Author information

1
Division of Oral and Dental Surgery, Department of Advanced Medicine, Japanese National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan. Electronic address: tomohisa@ncgg.go.jp.
2
Department of Rehabilitation, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
3
Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan.

Abstract

PATIENTS:

A 53-year-old institutionalized male patient with a history of postoperative bilateral hypoglossal nerve injury was admitted for treatment of dysphagia. He experienced dysphagia involving oral cavity-to-pharynx bolus transportation because of restricted tongue movement and was treated with a palatal augmentation prosthesis (PAP), which resulted in improved bolus transportation, pharyngeal swallowing pressure, and clearance of oral and pharyngeal residue. The mean pharyngeal swallowing pressure at tongue base with the PAP (145.5±7.5mmHg) was significantly greater than that observed immediately after removal of the PAP (118.3±10.1mmHg; p<0.05; independent t-test). Dysphagia rehabilitation with the PAP was continued. Approximately 1 month after PAP application, the patient could orally consume three meals, with the exception of foods particularly difficult to swallow.

DISCUSSION:

The supporting contact between the tongue and palate enabled by the PAP resulted in improvement of bolus transportation, which is the most important effect of a PAP. The increase in pharyngeal swallowing pressure at the tongue base because of PAP-enabled tongue-palate contact might play an important role in this improvement. Since a PAP augments the volume of the palate, it enables easy contact between the tongue and palate, resulting in the formation of an anchor point for tongue movement during swallowing. Thus, application of a PAP increases the tongue force, especially that of the basal tongue.

CONCLUSION:

A palatal augmentation prosthesis helps improve pharyngeal swallowing pressure at the basal tongue region and might contribute to the decrease of oral as well as pharyngeal residue.

KEYWORDS:

Dysphagia; Palatal augmentation prosthesis; Pharyngeal swallowing pressure

PMID:
28233692
DOI:
10.1016/j.jpor.2017.01.006
[Indexed for MEDLINE]
Icon for Elsevier Science
11.
J Laryngol Otol. 2017 Feb;131(2):181-184. doi: 10.1017/S0022215116009816. Epub 2017 Jan 9.

Successful conservative treatment of an intracranial pneumatocele with post-traumatic hypoglossal nerve palsy secondary to diffuse temporal bone pneumocele: case report and review of the literature.

Author information

1
Department of Otolaryngology,Salford Royal NHS Foundation Trust,UK.
2
Department of Neuroradiology,Salford Royal NHS Foundation Trust,UK.

Abstract

BACKGROUND:

A pneumocele occurs when an aerated cranial cavity pathologically expands; a pneumatocele occurs when air extends from an aerated cavity into adjacent soft tissues forming a secondary cavity. Both pathologies are extremely rare with relation to the mastoid. This paper describes a case of a mastoid pneumocele that caused hypoglossal nerve palsy and an intracranial pneumatocele.

CASE REPORT:

A 46-year-old man presented, following minor head trauma, with hypoglossal nerve palsy secondary to a fracture through the hypoglossal canal. The fracture occurred as a result of a diffuse temporal bone pneumocele involving bone on both sides of the hypoglossal canal. Further slow expansion of the mastoid pneumocele led to a secondary middle fossa pneumatocele. The patient refused treatment and so has been managed conservatively for more than five years, and he remains well.

CONCLUSION:

While most patients with otogenic pneumatoceles have presented acutely in extremis secondary to tension pneumocephalus, our patient has remained largely asymptomatic. Aetiology, clinical features and management options of temporal bone pneumoceles and otogenic pneumatoceles are reviewed.

KEYWORDS:

Hypoglossal Nerve; Mastoid; Pneumocephalus

PMID:
28067182
DOI:
10.1017/S0022215116009816
[Indexed for MEDLINE]
Icon for Cambridge University Press
12.
Neurol Res. 2017 Feb;39(2):183-188. doi: 10.1080/01616412.2016.1275461. Epub 2017 Jan 4.

Stereological assessment of the total number of hypoglossal neurons after repeated crush injuries to the hypoglossal nerve in adult rats.

Author information

1
a Department of Anatomy , Shinshu University School of Medicine , Matsumoto , Japan.

Abstract

OBJECTIVE:

Retrograde neuronal cell death does not occur in mature motoneurons following the axonal injury of peripheral nerves. However, a previous study suggested that retrograde neuronal cell death does occur in adult rats after the creation of double lesions on the hypoglossal (XII) nerve based on a substantial decrease in the number of XII neurons. Using stereological methods, we examined neuronal apoptosis in XII neurons and the total number of XII neurons following repeated crush injuries to the XII nerve.

METHODS:

The right XII nerve of adult rats was crushed three times at one-week intervals with a brain aneurysm clip. At 4 weeks after the final crush, the total numbers of XII neurons on the injured right and uninjured left sides were estimated stereologically.

RESULTS:

After repeated crush injuries, no apoptosis was evident in XII neurons as indicated by immunostaining for cleaved caspase-3. Moreover, immunohistochemistry for the vesicular acetylcholine transporter revealed axonal elongation in the tongue 4 weeks after repeated crush injuries. At 4 weeks, the total numbers of XII neurons were 7800 ± 290 on the injured right side and 8000 ± 230 on the uninjured left side, and no significant difference was evident between the injured and uninjured sides.

CONCLUSION:

Neuronal cell death does not occur in XII neurons and the total number of XII neurons does not decrease after repeated crush injuries of the XII nerve in adult rats.

KEYWORDS:

Hypoglossal nerve; adult rats; crush injury; neuron number; neuronal cell death; stereology

PMID:
28051949
DOI:
10.1080/01616412.2016.1275461
[Indexed for MEDLINE]
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13.
J Cardiothorac Vasc Anesth. 2016 Dec;30(6):1649-1651. doi: 10.1053/j.jvca.2015.12.004. Epub 2015 Dec 3.

A Man With No Voice.

Author information

1
Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, UK. Electronic address: ke.edwards@sky.com.

KEYWORDS:

Tapia’s syndrome; hypoglossal nerve; recurrent laryngeal nerve; vocal cord paralysis

PMID:
27053157
DOI:
10.1053/j.jvca.2015.12.004
[Indexed for MEDLINE]
Icon for Elsevier Science
14.
Glia. 2015 Jun;63(6):1073-82. doi: 10.1002/glia.22802. Epub 2015 Feb 17.

A DAP12-dependent signal promotes pro-inflammatory polarization in microglia following nerve injury and exacerbates degeneration of injured neurons.

Author information

1
Department of Functional Anatomy and Neuroscience, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Abstract

Under pathological conditions, activated microglia play paradoxical roles and could have neurotoxic or neuroprotective effects. However, the signal determining how activated microglia affects the fate of neuronal cells remains largely unknown. Here we demonstrate that DNAX-activating protein of 12 kDa (DAP12), a transmembrane adaptor protein that contains an immunoreceptor tyrosine-based activation motif, is a critical regulator of microglial function after nerve injury. In a model of mouse hypoglossal nerve injury, the duration of microglial increase after nerve injury became shorter in mice lacking DAP12, although microglial morphology and total cell numbers were not significantly affected during early phase after nerve injury. Intriguingly, expressions of M1-phenotype markers including pro-inflammatory cytokines were suppressed in DAP12-deficient microglia. Furthermore, axotomy-induced motor neuron death was markedly prevented in DAP12-deficient mice. Collectively, DAP12-mediated microglial activation following axotomy promotes pro-inflammatory responses, and thereby accelerates nerve injury-induced neuron death, suggesting that DAP12 is a potential therapeutic target for the protection of neuronal degeneration caused by microglial activation.

KEYWORDS:

ITAM; axotomy; inflammation; motor neuron; neuron death; neurotoxicity

PMID:
25690660
DOI:
10.1002/glia.22802
[Indexed for MEDLINE]
Icon for Wiley
15.
Anesth Analg. 2015 Jan;120(1):105-20. doi: 10.1213/ANE.0000000000000495.

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

Author information

1
From the *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; and †Institute for Translational Health Sciences, University of Washington, Seattle, Washington.

Abstract

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.

PMID:
25625257
PMCID:
PMC4308816
DOI:
10.1213/ANE.0000000000000495
[Indexed for MEDLINE]
Free PMC Article
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16.
Ann Vasc Surg. 2015 Feb;29(2):365.e17-8. doi: 10.1016/j.avsg.2014.09.029. Epub 2014 Nov 24.

Acute tongue swelling, the only initial manifestation of carotid artery dissection: a case report with differentiation of clinical picture.

Author information

1
Department of Oral and Maxillofacial Surgery, Peterborough City Hospital, Peterborough, UK. Electronic address: ryan.patrick.1@gmail.com.
2
Department of Oral and Maxillofacial Surgery, Peterborough City Hospital, Peterborough, UK.

Abstract

While it is well known that carotid artery dissection can cause hypoglossal palsy, which can cause muscle atrophy and fat tissue replacement in the chronic stage but what is less well known is the acute edematous stage, which can mimic tongue angioedema. We present a case report of a 52-year-old man presented to accident and emergency department with 3 hr history of right-side tongue swelling. He was initially diagnosed with angioedema and treated with corticosteroids and antihistamines. His tongue swelling persisted and subsequently developed unilateral weakness. Magnetic resonance imaging scan of the tongue, head, and neck revealed denervation of the right half of the tongue because of injury to hypoglossal nerve during extracranial internal carotid artery (ICA) dissection. There was no evidence of ischemic complication of right cerebral artery distribution. He was commenced on antiplatelet therapy to prevent cerebral ischemia as a prophylactic measure. Swelling and weakness of the tongue subsided in the following months. We believe that hypoglossal palsy caused by ICA dissection should be considered in the differential diagnosis of patients who present with acute tongue swelling.

PMID:
25463346
DOI:
10.1016/j.avsg.2014.09.029
[Indexed for MEDLINE]
Icon for Elsevier Science
17.
Braz J Anesthesiol. 2014 Mar-Apr;64(2):124-7. doi: 10.1016/j.bjane.2012.12.003. Epub 2013 Oct 11.

Transient unilateral combined paresis of the hypoglossal nerve and lingual nerve following intubation anesthesia.

Author information

1
Department of Anesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. Electronic address: hulyaulusoy.md@gmail.com.
2
Department of Anesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Abstract

Nerve damage may occur in the pharyngolaryngeal region during general anesthesia. The most frequently injured nerves are the hypoglossal, lingual and recurrent laryngeal. These injuries may arise in association with several factors, such as laryngoscopy, endotracheal intubation and tube insertion, cuff pressure, mask ventilation, the triple airway maneuver, the oropharyngeal airway, manner of intubation tube insertion, head and neck position and aspiration. Nerve injuries in this region may take the form of an isolated single nerve or of paresis of two nerves together in the form of hypoglossal and recurrent laryngeal nerve palsy (Tapia's syndrome). However, combined injury of the lingual and hypoglossal nerves following intubation anesthesia is a much rarer condition. The risk of this damage can be reduced with precautionary measures. We describe a case of combined unilateral nervus hypoglossus and nervus lingualis paresis developing after intubation anesthesia.

KEYWORDS:

Hypoglossal paralysis; Intubation anesthesia; Lingual paralysis

PMID:
24794456
DOI:
10.1016/j.bjane.2012.12.003
[Indexed for MEDLINE]
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18.
Arch Oral Biol. 2014 Jun;59(6):616-20. doi: 10.1016/j.archoralbio.2014.02.012. Epub 2014 Feb 28.

Quantitative analysis of survival of hypoglossal neurons in neonatally nerve-injured rats: Correlation with milk intake.

Author information

1
Department of Anatomy, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan. Electronic address: nanae@shinshu-u.ac.jp.
2
Department of Anatomy, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.

Abstract

INTRODUCTION:

Tongue movement innervated by the hypoglossal (XII) nerve is essential for the survival of neonatal rats. The pups with bilateral XII nerve resection failed to suckle milk and did not survive, and the pups with unilateral XII nerve resection showed disturbed suckling capability and lower survival rates. The present study was performed to investigate the relation between neuronal population and milk intake of developing rats that had received various degrees of crush injuries to the unilateral XII nerve during the neonatal period.

METHODS:

The right XII nerve of postnatal day 1 (P1) pups was crushed and milk intake was estimated at 3 days and 6 days after the nerve injury. As nerve injury at the neonatal stage results in death of axotomized neurons, varying degrees of crushing was estimated by the number of survived motor neurons.

RESULTS:

In nerve-crushed rats, the populations of XII motor neurons and amounts of milk intake were reduced in a varied manner. Statistically significant positive correlations were observed between increasing XII neuron survival and increasing milk intake at 3 (r=0.62) and 6 (r=0.71) days after the nerve injury.

CONCLUSION:

The results indicate that there is a strong relationship between the number of XII motor neurons and the amount of milk intake in neonatally XII nerve-injured rats.

KEYWORDS:

Crush injury; Hypoglossal nerve; Hypoglossal nucleus; Neonatal rats; Suckling

[Indexed for MEDLINE]
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19.
J Clin Sleep Med. 2014 Jan 15;10(1):97-8. doi: 10.5664/jcsm.3372.

Two-year-old with post-surgical hypoglossal nerve injury and obstructive sleep apnea.

Author information

1
Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA.
2
Department of Radiology, Louisiana State University School of Medicine, Shreveport, LA.

Abstract

BACKGROUND:

Airway patency in both children and adults depends on the tonic and phasic activation of muscles of the tongue and pharynx supplied by the hypoglossal nerve arising at the medullary level.

METHODS/PATIENT:

We report a case of a 2-year-old who after resection of fourth ventricle anaplastic ependymoma developed severe sleep disordered breathing and tongue fasciculation.

RESULTS:

Polysomnography showed severe obstructive sleep apnea with oxygen desaturation to 33%. Magnetic resonance imaging of the brain showed post-surgical effacement of the dorsal lateral medulla.

CONCLUSIONS:

We postulate that damage to the hypoglossal nerve at the level of the medulla contributed to the patient's severe obstructive sleep apnea. Patient was treated with tracheostomy.

KEYWORDS:

Hypoglossal nerve injury; pediatric OSA; sleep disordered breathing; tracheostomy

PMID:
24426827
PMCID:
PMC3869077
DOI:
10.5664/jcsm.3372
[Indexed for MEDLINE]
Free PMC Article
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20.
Neuroscience. 2014 Jan 3;256:426-32. doi: 10.1016/j.neuroscience.2013.10.055. Epub 2013 Oct 31.

microRNA-124 is down regulated in nerve-injured motor neurons and it potentially targets mRNAs for KLF6 and STAT3.

Author information

1
Laboratory for Proteolytic Neuroscience, RIKEN Brain Science Institute, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan.
2
Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
3
Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan; Department of Functional Anatomy & Neuroscience, Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan; CREST, JST, Nagoya University, Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan.
4
Department of Anatomy and Neurobiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan; Department of Functional Anatomy & Neuroscience, Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan; CREST, JST, Nagoya University, Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya 466-8550, Japan. Electronic address: kiyama@med.nagoya-u.ac.jp.

Abstract

MicroRNA (miRNA) is a small non-coding RNA that regulates gene expression by degrading target mRNAs or inhibiting translation. Although many miRNAs play important roles in various conditions, it is unclear whether miRNAs are involved in motor nerve regeneration. In this study, we identified the possible implication of miR-124 in nerve regeneration using a mouse hypoglossal nerve injury model. The significant down-regulation of miR-124 was observed in injured hypoglossal motor neurons after nerve injury, and this transient down-regulation showed a clear inverse correlation with the up-regulation of KLF6 and STAT3, known as axon elongation factor and regeneration-associated molecules, respectively. Furthermore, the luciferase assay and in vitro gain of function methods supported that both genes could be potent targets of miR-124. These results suggest that injury-induced repression of miR-124 may be implicated in the regulation of expression of several injury-associated transcription factors, which are crucial for appropriate nerve regeneration.

KEYWORDS:

3′-UTR; 3′-untranslated region; CT; IL6 receptor; IL6R; ISH; KLF6; Krüppel-like factor 6; STAT3; cycle threshold; expression regulation; hypoglossal nerve; in situ hybridization histochemistry; miRNA; microRNA; nerve injury; neuronal regeneration; signal transducer and activator of transcription 3; transcription factor

[Indexed for MEDLINE]
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