Iatrogenic hypoglossal nerve palsy, a rare complication post suspension laryngoscopy

Yusof, Johannas Mohd; Dahari, Khairul Azlan Shahril Abu; Kaur, Narindev; Azman, Mawaddah

doi:10.1016/j.jtumed.2021.09.012

“…Such circumstances can lead to secondary compression, traction, and ischemia [88,89]. Although injuries resulting from cervical spine surgeries are mostly reversible and present satisfying outcomes after conservative treatment, permanent damage has been reported [90]. In addition, tumor excisions (including thyroidectomies), tonsillectomies and, in very rare cases, submandibular gland excisions (<1.4%) can also pose a direct risk to the HN [15,91,92].…”

Section: Other Surgeriesmentioning

confidence: 99%

“…Additional factors might be stretching of the nerve on the anterior aspect of the transverse process of the C1 vertebra, which is provoked by neck hyperextension or compression between the laryngoscope blade and the pathologically calcified stylohyoid ligament. Both direct and suspension laryngoscopy can affect the HN [90,95,111].…”

Section: Intubationmentioning

confidence: 99%

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Węgiel,

Zielinska,

Głowacka

et al. 2024

Biomedicines

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The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

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Case Report: Tongue deviation due to supranuclear injury with a rare semiological feature

Santander Maury,

Muñoz Rodriguez,

Camargo Camargo

2024

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Abstract* Hypoglossal nerve injuries are classified according to their anatomical localization in: Infranuclear, nuclear, and supranuclear. Supranuclear injuries can occur in cerebral cortex, corticobulbar tracts, internal capsule, cerebral peduncles, or in the pons, and most often caused by a stroke. These lesions usually do not generate a significant alteration of tongue motility due to the bilateral innervation of both nuclei from the cortex. We present a case of a 43-year-old male with dysarthria, left central facial paralysis, and an important tongue palsy and deviation to the same side. Brain CT revealed a right frontotemporal stroke with little hemorrhagic transformation, and an EKG that showed auricular fibrillation. He received treatment with amiodarone and rivaroxaban was initiated when a second brain CT scan showed no evidence of hemorrhage. This case is remarkable due the unusual presentation in a supranuclear lesion of the hypoglossal nerve. It is important to enrich the semiology and consider the possibility of cortical cerebrovascular events in patients with acute deviation of the tongue, even in the absence of involvement of other cranial nerves; or marked ipsilateral motor implication.

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Case Report: Tongue deviation due to supranuclear injury with a rare semiological feature

Santander Maury,

Muñoz Rodriguez,

Camargo Camargo

2024

F1000Res

0

View full text Add to dashboard Cite

Abstract* Hypoglossal nerve injuries are classified according to their anatomical localization in: Infranuclear, nuclear, and supranuclear. Supranuclear injuries can occur in cerebral cortex, corticobulbar tracts, internal capsule, cerebral peduncles, or in the pons, and most often caused by a stroke. These lesions usually do not generate a significant alteration of tongue motility due to the bilateral innervation of both nuclei from the cortex. We present a case of a 43-year-old male with dysarthria, left central facial paralysis, and an important tongue palsy and deviation to the same side. Brain CT revealed a right frontotemporal stroke with little hemorrhagic transformation, and an EKG that showed auricular fibrillation. He received treatment with amiodarone and rivaroxaban was initiated when a second brain CT scan showed no evidence of hemorrhage. This case is remarkable due the unusual presentation in a supranuclear lesion of the hypoglossal nerve. It is important to enrich the semiology and consider the possibility of cortical cerebrovascular events in patients with acute deviation of the tongue, even in the absence of involvement of other cranial nerves; or marked ipsilateral motor implication.

show abstract

Iatrogenic hypoglossal nerve palsy, a rare complication post suspension laryngoscopy

Cited by 3 publications

References 8 publications

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Case Report: Tongue deviation due to supranuclear injury with a rare semiological feature

Case Report: Tongue deviation due to supranuclear injury with a rare semiological feature

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