• 제목/요약/키워드: Paralysis of hypoglossal nerve

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설하 신경 마비로 인한 설마비 환자 치험 1례 (A Case Study of Hypoglossal Nerve Palsy Patient with Tongue Paralysis Treated with Korean Medical Treatment)

  • 이재형;한성준;이엄지;이정은;남성욱;하나연;김진성
    • 대한한방내과학회지
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    • 제37권5호
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    • pp.870-875
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    • 2016
  • Hypoglossal nerve palsy is an uncommon neurologic disorder. We report a 67-year-old Korean male with tongue paralysis due to hypoglossal nerve palsy. He had complaints associated only with tongue paralysis and was treated with herbal medicine and electric acupuncture for 12 days. We evaluated his tongue paralysis severity by a numeric rating scale (NRS) and the angle of tongue deviation. After 12 days of treatment, the NRS score showed improvement of his complaints, and the angle of tongue deviation was decreased. Korean medicine could therefore be an effective treatment choice for hypoglossal nerve palsy.

경구강 악하선 절제술 후 발생한 반대측 설하신경 마비 1례 (A Case of Contralateral Hypoglossal Nerve Palsy after Peroral Resection of Submandibular Gland)

  • 반원우;반명진;이치규;박재홍
    • 대한두경부종양학회지
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    • 제32권1호
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    • pp.41-44
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    • 2016
  • The resection of submandibular gland is usually performed via trascervical, transoral approach. The authors suspected the stenosis of Wharton's duct of 54 years old female patient after transoral removal of submandibular stone and the resection of submandibular gland was decided. Because of cosmetic need, the resection was performed transorally. The operation was completed successfully without any injury to unilateral lingual nerve or hypoglossal nerve but contralateral paralysis of hypoglossal nerve was seen. In our knowledge, this is the first report of contralateral hypoglossal nerve palsy during transoral resection of submandibular gland.

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

  • Koo, Won Young;Park, Seong Oh;Ahn, Hee Chang;Ryu, Soo Rack
    • 대한두개안면성형외과학회지
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    • 제22권6호
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    • pp.303-309
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    • 2021
  • Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

Unilateral hypoglossal nerve palsy after mild COVID-19: a case report

  • Sang Jae Lee;Si-Youn Song;Hyung Gyun Na;Chang Hoon Bae;Yong-Dae Kim;Yoon Seok Choi
    • Journal of Medicine and Life Science
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    • 제20권2호
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    • pp.103-106
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    • 2023
  • Post-acute coronavirus disease (COVID-19) syndrome is defined as persistent symptoms or delayed complications after COVID-19. Several cases of cranial nerve invasion related to COVID-19 have been reported. However, to our knowledge, no cases of solitary unilateral hypoglossal nerve paralysis after mild COVID-19 without intubation have been reported to date. Herein, we report the case of a 64-year-old man with unilateral hypoglossal nerve palsy as a complication of COVID-19. He complained of dysarthria and tongue discomfort 2 weeks after COVID-19 onset. Brain and neck computed tomography, magnetic resonance imaging, ultrasonography, and blood tests ruled out other possible causes. The patient's nerve palsy was rapidly diagnosed and improved with early rehabilitation. Understanding of the pathology of COVID-19 is still limited. Physicians should focus on patients' symptoms and their relationship to COVID-19, and investigate complications immediately. This case highlights the importance of early detection and rehabilitation of post-acute COVID-19 syndrome.

Facial palsy reconstruction

  • Soo Hyun Woo;Young Chul Kim;Tae Suk Oh
    • 대한두개안면성형외과학회지
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    • 제25권1호
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    • pp.1-10
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    • 2024
  • The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

신경추적자(神經追跡子)를 이용한 얼굴신경마비(神經痲痺)와 관련(關聯)된 혈(穴)들을 지배(支配)하는 신경세포체(神經細胞體)의 표식부위(標識部位)에 대(對)한 형태학적(形態學的) 연구(硏究) (Morphological Studies on the Localization of Neurons Projecting to the Meridian Points Related to the Facial Nerve Paralysis in the Rat Using the Neural Tracers)

  • 김점영;이상룡;이창현
    • 대한한의학회지
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    • 제18권1호
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    • pp.58-71
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    • 1997
  • In order to the location and local arrangement of nerve cell bodies and nerve fibers projecting to the meridian points related to facial nerve paralysis in the rat using the neural tracers, CTB and WGA-HRP, labeled neurons the were investigated by immunohistochemical and HRP histochemical methods following injection of 2.5% WGA-HRP and 1% CTB into Hyopko$(S_6)$. Chichang$(S_4)$, Sugu$(GV_{26})$, Sajukkong$(TE_{23})$ and Yangbaek$(G_{14})$. Following injection of Hyopko$(S_6)$, Chichang$(S_4)$, labeled motor neurons were founded in facial nucleus, trigeminal motor nucleus, reticular nucleus and hypoglossal nucleus. labeled sensory neurons were founded in trigeminal ganglia and $C_{1-2}$ spinal ganglia. sympathetic motor neurons were found in superior cervical ganglia. Sensory fibers labeled in brainstem were found in mesencephalic trigeminal tract, sensory root of trigeminal nerve, oral, interpolar and caudal part of trigeminal nucleus, area postrema, nucleus tractus solitarius, lateral reticular nucleus and $C_{1-2}$ spinal ganglia. Following injection of Sugu$(GV_{26})$, labeled motor neurons were founded in facial nucleus. Labeled sensory neurons were founded in trigeminal ganglia and $C_{1-2}$ spinal ganglia. Sympathetic motor neurons were found in superior cervical ganglia. Sensory fibers labeled in brainstem were found in spinal trigeminal tract, trigeminal motor nucleus, mesencephalic trigeminal tract, oral. interpolar and caudal parts of trigeminal nucleus, area postrema, nucleus tractus solitarius, lateral reticular nucleus, dorsal part of reticular part and $C_{1-2}$ spinal ganglia. Following injection of Sajukkong$(TE_{23})$ and Yangbaek$(G_{14})$, labeled motor neurons were founded in facial nucleus, trigeminal motor nucleus. Labeled sensory neurons were founded in trigeminal ganglia and $C_{1-2}$ spinal ganglia. sympathetic motor neurons were found in superior cervical ganglia. Sensory fibers labeled in brainstem were found in oral, interpolar and caudal parts of trigeminal nucleus, area postrema, nucleus tractus solitarius, inferior olovary nucleus, medullary reticular field and lamina I-IV of $C_{1-2}$ spinal cord. Location of nerve cell body and nerve fibers projecting to the meridian points related to the facial nerve paralysis in the rats were found in facial nucleus and trigeminal motor nucleus. Sensory neurone were found in trigeminal ganglia and $C_{1-2}$ spinal ganglia. Sympathetic motor neurons were found in superior cervical ganglia. Sensory fibers labeled in brainstem were found in mesencephalic trigeminal tract, oral, interpolar and caudal parts of trigeminal nucleus, area postrema, nucleus tractus solitarius. lateral reticular nucleus, medullary reticular field.

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흰쥐 안면신경핵 세포의 전기생리학적 및 형태학적 특성 (ELECTROPHYSIOLOGICAL AND MORPHOLOGICAL CHARACTERISTICS OF FACIAL NUCLEUS IN RAT)

  • 최병주;조진화;배용철;김영진
    • 대한소아치과학회지
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    • 제27권3호
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    • pp.400-409
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    • 2000
  • 흰쥐의 안면신경핵을 구성하는 신경세포들의 시냅스 연결 양태 및 세포막 특성을 규명하기 위해 in vivo 필드전위 및 세포 내 전위 측정법을 이용하여 전기생리적 반응을 관찰하였다. 말초 안면신경 분지를 역행성으로 전기자극시 자극세기에 비례하여 전위의 크기가 증가되었고 필드 전위의 양태는 두 가지 반응으로 나타났는데 전기자극 직후 1ms 부근에서 정점을 나타내는 양태와 이와 더불어 $7\sim8ms$ 부근에서 후기 정점을 동반하는 양태가 있었다. 안면신경핵은 염색시 내측, 배외측, 중간측 및 외측등 4부분의 소핵으로 구분되었다. Neurobiotin으로 채워진 단일 신경세포를 형태학적으로 재구축하였는데 세포체는 추체형태를 나타내었고 주 수상돌기는 모든 방향으로 뻗어져 있었고 각 수상돌기의 영역은 해당 소핵 내에 한정되어 있었다. 일련의 과분극 전류 $(-1.2\sim+1.2nA)$를 세포내에 가하였을 때 동반되는 세포내 전위변화를 입력저항 값으로 계산하였을 때 그 기울기가 직선형으로 나타났다. 탈분극 전류를 세포내 주입시 지속적인 활동성 전위가 나타났으며 전류의 크기에 비례하여 각 전위의 개수가 증가하였고 spike-빈도 적응 현상이 나타났다. 그러나 시간 의존성 내향성 정류현상은 관찰되지 않았고 anodal break excitation이 나타났다. 이상의 실험결과로 보아 안면신경핵을 구성하고 있는 세포들 사이의 시냅스는 다양한 형태로 존재할 가능성이 있다고 사료되며 이들 시냅스간의 변화를 통하여 안면 신경마비, 반쪽 안면 경련, hypoglossal-facial anastomosis등에서 나타날 수 있는 임상적 신경성 증상 기전을 설명할 수 있을 것으로 여겨진다.

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