• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.188-191
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• 2003

Schwannoma is a benign tumor of Schwann cell origin and may occur on any nerve covered by Schwann cells. Although approximately 25% to 48% of all Schwannoma occur in the head and neck region, the lesions originating from the cervical vagus nerve are extremely rare. We have recently experienced a case of huge Schwannoma arising from the cervical vagus nerve which was initially misdiagnosed as a huge goiter. We report herein the case with review of the literatures.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.423-425
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• 2013

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.115-117
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• 2022

"Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.241-245
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• 1997

Persistent hiccup is defined as duration lasting longer than 48 hours. Reflex arc of hiccup is divided into three parts : afferent, central, efferent. Afferent portion of the neural pathway of hiccup formation is composed of vagus nerve, phrenic nerve, and sympathetic chain arising from T6 to T12. Efferent limb is phrenic nerve. Hiccup center is located in brain stem, midbrain, reticular system and hypothalamus. Persistent hiccup is very difficult to treat by conventional methods. We performed cervical epidural block of the phrenic nerve root for three patients suffering from persistent hiccup. The therapeutic effect was perfect. The mechanism of the cervical epidural block is not yet defined however it is thought to block the efferent nerve fibers and suppress the reflex arc of hiccup. We conclude cervical epidural block is relatively safe and very effective for treating persistent hiccup.

• The Korean Journal of Physiology
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• v.6 no.2
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• pp.31-37
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• 1972

The right cervical vagus nerve was electrically stimulated for 30 sec, and 30 minutes recording cardiac rate responses and electrocardiogram. The main purposes of the present experiment are to determine effect of stimulation frequency on the maintenance of cardiac rate responses and to determine recovery time of sinus rhythm after asystole period followed by idioventricular rhythm during prolonged electrical stimulation of the vagus, and the optimal stimulation parameters for vagal stimulation were studied as well. The results obtained are summarized as follows: 1. The maximum negative chrontropic responses were obtained with the following ranges of electrical parameters. Intensity: 3V-7V, Frequency: 20/sec-60/sec, and pulse duration: 5 msec-20 msec. 2. Compared with the responses from sympathetic effectors, cardiac rate responses to electrical stimulation of vagus nerve were well maintained with all stimulation frequencies. 3. At all stimulation frequencies except 20/sec, sinus node started to take over primary pacemaker activity when cardiac rates were restored to about 38-40/min. 4. It was indicated that upper limit of idioventricular rhythm does not exceed 38-40/min. 5. With the stimulation parameter set of 20/sec-5 msec-3 V, sinus rhythm did not appear during 30 minutes of stimulation period. Therefore, this electrical parameter set appears to be optimal for elicitation of prolonged and maximum cardiac rate responses by vagal stimulation.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.455-465
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• 2023

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.224-227
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• 2000

Neurilemmomas are benign nerve sheath tumors arising from peripheral Schwann cells. The tumor composed of Schwann cells and collagen fibers, can occur in any region of the body where there is a nerve that has a Schwann sheath. The incidence of the tumor in the head and neck is about 30% with many of these occurring on the vagus nerve. Neurilemmoma is characterized by solitary occurrence, with sharp demarcation and encapsulation. Multiple genesis is very rare. This article presents a rare case of multiple neurilemmomas located bilaterally in the cervical region.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.1
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• pp.9-19
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• 1998

The present study was primarily carried out to characterize the properties of the spinomesencephalic tract (SMT) neurons that project from the upper cervical spinal segments to the midbrain. It was also investigated whether these neurons received convergent afferent inputs from other sources in addition to cervical inputs. Extracellular single unit recordings were made from neurons antidromically activated by stimulation of midbrain. Recording sites were located in lamina $I{\sim}VIII\;of\;C1{\sim}C3$ segments of spinal cord. Receptive field (RF) and response properties to mechanical stimulation were studied in 71 SMT neurons. Response profiles were classified into six groups: complex (Comp, n=9), wide dynamic range (WDR, n=16), low threshold (LT, n=5), high threshold (HT, n=6), deep/tap (Deep, n=10), and non- responsive (NR, n=25). Distributions of stimulation and recording sites were not significantly different between SMT groups classified upon their locations and/or response profiles. Mean conduction velocity of SMT neurons was $16.7{\pm}1.28\;m/sec$. Conduction velocities of SMTs recorded in superficial dorsal horn (SDH, n=15) were significantly slower than those of SMTs recorded in deep dorsal horn (DDH, n=18), lateral reticulated area (LRA, n=21), and intermediate zone and ventral horn (IZ/VH, n=15). Somatic RFs for SMTs in LRA and IZ/VH were significantly larger than those in SDH and DDH. Five SMT units (4 Comps and 1 HT) had inhibitory somatic RFs. About half (25/46) of SMT units have their RFs over trigeminal dermatome. Excitabilities of 5/12 cells and 9/13 cells were modulated by stimulation of ipsilateral phrenic nerve and vagus nerve, respectively. These results suggest that upper cervical SMT neurons are heterogenous in their function by showing a wide range of variety in location within the spinal gray matter, in response profile, and in convergent afferent input.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 1999.03a
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• pp.243-248
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• 1999

There is substantial evidence that anatomical connections and functional interactions exist between vestibular and autonomic systems. Heart rate variability (HRV) including mean, standard deviation, coefficient of variation (CV), power spectrum was analyzed for evaluation of the physiological role of the vestibular system on control of heart rate in rabbits. In anesthetized rabbits, electrical stimulation of the vagus nerve decreased heart rate and decreased LF/HF by increasing HF. On the cervical sympathetic nerve increased heart rate and increased LF/HF by increasing LF. Atropine, cholinergic blocker, increased heart rate and increased LF/HF by reducing HF, and propranolol, ${\beta}$-adrenergic blocker, decreased heart rate and decreased LF/HF by reducing LF> In unanesthetized rabbits, stimulation of the vestibular system induced by rotation or caloric increased heart rate and increased LF/HF by increasing LF> Also electrical stimulation of the vestibular nerve produced the same of effects as rotation or caloric in anesthetized rabbits. These results suggest that Stimulation of the vestibular system increased heart rate not by inhibiting the parasympathetic nerve but by activating the sympathetic nerve.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.131-134
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• 1995

Hiccup is characterized by a myoclonus in the diaphragm, resulting in a sudden inspiration associated with an audible closure of the glottis. The reflex arc in hiccups comprises three pars: an afferent, a central and an efferent part. The afferent portion of the neural pathway of hiccup formation is composed of the vagus nerve, the phrenic nerve, and the sympathetic chain arising from T6 to T12. The hiccup center is localised in the brain stem and the efferent limb comprises phrenic pathways. All stimuli affecting the above mentioned reflex arc may produce hiccups. The pathogenesis of persistent hiccups is not known. Hiccup can present a symptom of a subphrenic abscess or gastric distention, and metabolic alterations may also cause hiccups. Numerous treatment modalities have been tried but with questionable success. We describe a patient whose persistant hiccups was treated successfully by a cervical epidural block.