Hypoglossal nerve paralysis following tonsillectomy

Sharp, C; Borg, Hanna; Kishore, A.; MacKenzie, K.

doi:10.1258/0022215021910870

Cited by 23 publications

(4 citation statements)

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“…During reresection for positive margins, the airway was lost on one patient necessitating an operative cricothyrotomy. One patient developed bilateral hypoglossal nerve paresis, a documented stretch‐related complication of endoscopic approaches to the pharynx (e.g., tonsillectomy) 14. Nine patients demonstrated postoperative velopharyngeal incompetence, although none severe enough to prevent oral intake or good speech intelligibility.…”

Section: Resultsmentioning

confidence: 99%

Transoral laser microsurgery (TLM) ± adjuvant therapy for advanced stage oropharyngeal cancer

et al. 2009

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Objectives/Hypothesis Document survival, prognostic variables, and functional outcomes of patients with AJCC stage III or IV oropharyngeal cancer, treated with transoral laser microsurgery (TLM) ± adjuvant therapy. Study Design Analysis of prospectively assembled data pertaining to the above-described patient cohort. Methods Patients treated with TLM for AJCC stage III or IV oropharyngeal cancer at Washington University School of Medicine from 1996 to 2006 were followed for a minimum of 2 years. Recurrence, survival, functional, and human papilloma virus data were analyzed. Results Eighty-four patients met inclusion criteria. Mean follow-up was 52.6 months. Overall AJCC stages were: III 15% and IV 85%. T stages were T1–2, 74%; T3–4, 26%. Eighty-three patients underwent neck dissection, 50 received adjuvant radiotherapy, and 28 received adjuvant chemoradiotherapy. Overall survival at 2 and 5 years was 94% and 88%, respectively. Disease-specific survival at 2 and 5 years was 96% and 92%, respectively. Six patients recurred (7%): locally (one), regionally (four), and distant (five). T stage, positive margins, and p16 status significantly impacted survival. The addition of adjuvant chemo-therapy in high-risk patients did not significantly impact survival. Five patients (6%) had major surgical complications, but without mortality. Eighty-one percent of patients had acceptable swallowing function at last follow-up. Immediately postoperatively, 17% required G-tubes, which dropped to 3.4% of living patients at 3 years. Conclusions In this population, our findings validate TLM ± adjuvant therapy as a highly effective strategy for survival, locoregional control, and swallowing recovery in AJCC stage III and IV oropharyngeal cancer. Our finding also show that p16 positivity improves survival.

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Section: Resultsmentioning

confidence: 99%

Transoral laser microsurgery (TLM) ± adjuvant therapy for advanced stage oropharyngeal cancer

et al. 2009

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“…10 Clinical Relevance of Peripheral Hypoglossal Nerve Injury Rapid and accurately adjusted tongue movements are paramount for a wide range of functions, including breathing, swallowing, licking/mastication, gaping, gagging, coughing, sneezing, vocalization, and vomiting. 15,33,34 Although hypoglossal nerve injury has anecdotally been considered rare, lesions may result from tumors, 35 trauma, 36 tonsillectomy, 37 anterior cervical spinal surgery, 38 orotracheal intubation, 39 carotid end-arterectomy, 40,41 and use as donor tissue for facial reanimation surgery. 16 Unilateral hypoglossal damage is considered clinically to be well tolerated due to preservation of taste and tactile sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Manual Stimulation of the Suprahyoid-Sublingual Region Diminishes Polynnervation of the Motor Endplates and Improves Recovery of Function After Hypoglossal Nerve Injury in Rats

Evgenieva

Schweigert

Guntinas‐Lichius³

et al. 2008

Neurorehabil Neural Repair

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“…There are also reports of carotid and vertebral artery dissections leading to hypoglossal nerve injury. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] In a large case series of hypoglossal nerve palsies, the site of the lesion could not be localized in 6%. 9 In the radiologic diagnostic work-up, a segmental imaging approach is advised.…”

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confidence: 99%

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

Meng¹,

Reissig²,

Tzou

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The hypoglossal nerve, providing motor innervation for the tongue, can be affected in many diseases of the neck and skull base, leading to dysarthria, dysphagia, and ultimately atrophy of the tongue. We determined the feasibility of direct visualization of the hypoglossal nerve in the neck with ultrasound, testing this technique on healthy volunteers and evaluating it in clinical practice.

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Hypoglossal nerve paralysis following tonsillectomy

Cited by 23 publications

References 0 publications

Transoral laser microsurgery (TLM) ± adjuvant therapy for advanced stage oropharyngeal cancer

Transoral laser microsurgery (TLM) ± adjuvant therapy for advanced stage oropharyngeal cancer

Manual Stimulation of the Suprahyoid-Sublingual Region Diminishes Polynnervation of the Motor Endplates and Improves Recovery of Function After Hypoglossal Nerve Injury in Rats

Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients

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