Studies have shown that sensory nerve damage can activate the p38 mitogen-activated protein kinase（MAPK）pathway,but whether the same type of nerve injury after exercise activates the p38MAPK pathway remains unclear....Studies have shown that sensory nerve damage can activate the p38 mitogen-activated protein kinase（MAPK）pathway,but whether the same type of nerve injury after exercise activates the p38MAPK pathway remains unclear.Several studies have demonstrated that nerve growth factor may play a role in the repair process after peripheral nerve injury,but there has been little research focusing on the hypoglossal nerve injury and repair.In this study,we designed and established rat models of hypoglossal nerve crush injury and gave intraperitoneal injections of exogenous nerve growth factor to rats for 14 days.p38MAPK activity in the damaged neurons was increased following hypoglossal nerve crush injury;exogenous nerve growth factor inhibited this increase in acitivity and increased the survival rate of motor neurons within the hypoglossal nucleus.Under transmission electron microscopy,we found that the injection of nerve growth factor contributed to the restoration of the morphology of hypoglossal nerve after crush injury.Our experimental findings indicate that exogenous nerve growth factor can protect damaged neurons and promote hypoglossal nerve regeneration following hypoglossal nerve crush injury.展开更多
Objective To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial ‘side＇-to-side neurorrhaphy in rats. Methods A total of 30 adult rats with crushed and bulld...Objective To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial ‘side＇-to-side neurorrhaphy in rats. Methods A total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups（n = 6 each） that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement. Results At 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed. Conclusion The results of this study demonstrated that hemi HN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.展开更多
Schwannomas originating from the hypoglossal nerve are extremely rare neoplasms. Hypoglossal schwannomas usually occur between the third and fifth decades of life, with no sex predilection, commonly presenting as a pa...Schwannomas originating from the hypoglossal nerve are extremely rare neoplasms. Hypoglossal schwannomas usually occur between the third and fifth decades of life, with no sex predilection, commonly presenting as a painless, slow-growing, and lateral neck mass. The best treatment is complete surgical excision with preservation of the neural pathway, if possible. In fact, since these tumors are almost always benign, a conservative surgical approach is emphasized by most authors. We report a case of a large schwannoma of hypoglossal nerve origin in the upper neck in a 31-year-old male. Magnetic resonance imaging of the area demonstrated a 43 × 39 × 36 mm well-circumscribed mass with high and nonhomogeneous signal intensity on the right side of the upper neck. The lesion was successfully treated by extirpation, with no recurrence. The extracranial hypoglossal nerve sheath was as the origin of this tumor because the patient experienced remarkable disturbance of tongue motility after surgery.展开更多
A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were dis...A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were discovered, and left radical neck dissection was performed. Postoperatively, airway obstruction occurred despite performing extubation after confirming that the patient had fully recovered from anesthesia. Bilateral hypoglossal nerve palsy was diagnosed and the patient was reintubated. After extubation on the following day, airway obstruction was relieved, but slurred speech and impaired swallowing were persistent. In view of this, hypoglossal nerve function should be examined before the second radical neck dissection on the contralateral side.展开更多
Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one ...Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one or more of cranial nerves IX,X,XI,and XII.We present a case of malignant otitis externa which presented with symptomatic palsy of IX and XII nerves sparing the VII cranial nerve.The patient though later on had internal jugular vein thrombosis,which we presume is due to the involvement of the parapharyngeal space that prompted us to reconsider the diagnosis,and later on,to aggravate the therapy.With proper blood sugar control and appropriate long term antibiotics,not only that the patient is disease free at one year follow up,but the cranial nerve deficits also recovered.Apart from sharing the clinical and management details of this patient,we have reviewed the relevant literature in the discussion,which has shed some light onto some of the interesting facts about this condition and its prognosis.展开更多
Godtfredsen syndrome or clival syndrome is a rare syndrome of abducens and hypoglossal nerve palsies (cranial nerve 6th and 12th respectively) that localizes to a clival mass. There are few reported cases of this clin...Godtfredsen syndrome or clival syndrome is a rare syndrome of abducens and hypoglossal nerve palsies (cranial nerve 6th and 12th respectively) that localizes to a clival mass. There are few reported cases of this clinical presentation. The aim of this case report is to describe this rare manifestation observed in a woman with clival metastases arising from a thymoma. A previously well 34-year-old native lady presented to a district hospital in Sabah, Malaysia, with history of blurring of vision and headache for 1 month. Cranial nerve examination reveals right abducens nerve palsy (right 6th CN) and right hypoglossal nerve palsy (right 12th CN). Initial imaging with CT brain reveals a subtle extra-axial hyperdense mass adjacent to the clivus and a routine chest x-ray reveals a mediastinal mass. Further imaging of thorax showed right anterior mediastinal mass, which then proceeded with Video-Assisted Thoracoscopic Surgery (VATS) guided biopsy. The biopsy result was consistent with the finding of thymoma, type B2. She was then diagnosed with aggressive form of thymoma, which unfortunately has metastasized to the bone, lung, liver and brain. Despite prognosis at the time of diagnosis is guarded, she still opted to undergo chemotherapy. Despite the completion of 6 cycles of chemotherapy, her disease progressed, and she eventually succumbed to the illness. In short, the presence of combined 6th and 12th palsy should alert clinician to the possibility of clival mass or metastases and hence could earlier workup with appropriate imaging can lead to earlier diagnosis and better treatment outcome.展开更多
文摘Studies have shown that sensory nerve damage can activate the p38 mitogen-activated protein kinase（MAPK）pathway,but whether the same type of nerve injury after exercise activates the p38MAPK pathway remains unclear.Several studies have demonstrated that nerve growth factor may play a role in the repair process after peripheral nerve injury,but there has been little research focusing on the hypoglossal nerve injury and repair.In this study,we designed and established rat models of hypoglossal nerve crush injury and gave intraperitoneal injections of exogenous nerve growth factor to rats for 14 days.p38MAPK activity in the damaged neurons was increased following hypoglossal nerve crush injury;exogenous nerve growth factor inhibited this increase in acitivity and increased the survival rate of motor neurons within the hypoglossal nucleus.Under transmission electron microscopy,we found that the injection of nerve growth factor contributed to the restoration of the morphology of hypoglossal nerve after crush injury.Our experimental findings indicate that exogenous nerve growth factor can protect damaged neurons and promote hypoglossal nerve regeneration following hypoglossal nerve crush injury.
基金supported by the Basic-Clinical scientific research cooperation fund of Capital Medical University[Grant No.14JL49]+1 种基金the National Natural Science Foundation of China[Grant No.31440051]Special fund for scientific research on health development in the capital[Grant No.2014-2-1073]
文摘Objective To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial ‘side＇-to-side neurorrhaphy in rats. Methods A total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups（n = 6 each） that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement. Results At 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed. Conclusion The results of this study demonstrated that hemi HN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.
文摘Schwannomas originating from the hypoglossal nerve are extremely rare neoplasms. Hypoglossal schwannomas usually occur between the third and fifth decades of life, with no sex predilection, commonly presenting as a painless, slow-growing, and lateral neck mass. The best treatment is complete surgical excision with preservation of the neural pathway, if possible. In fact, since these tumors are almost always benign, a conservative surgical approach is emphasized by most authors. We report a case of a large schwannoma of hypoglossal nerve origin in the upper neck in a 31-year-old male. Magnetic resonance imaging of the area demonstrated a 43 × 39 × 36 mm well-circumscribed mass with high and nonhomogeneous signal intensity on the right side of the upper neck. The lesion was successfully treated by extirpation, with no recurrence. The extracranial hypoglossal nerve sheath was as the origin of this tumor because the patient experienced remarkable disturbance of tongue motility after surgery.
文摘A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were discovered, and left radical neck dissection was performed. Postoperatively, airway obstruction occurred despite performing extubation after confirming that the patient had fully recovered from anesthesia. Bilateral hypoglossal nerve palsy was diagnosed and the patient was reintubated. After extubation on the following day, airway obstruction was relieved, but slurred speech and impaired swallowing were persistent. In view of this, hypoglossal nerve function should be examined before the second radical neck dissection on the contralateral side.
文摘Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one or more of cranial nerves IX,X,XI,and XII.We present a case of malignant otitis externa which presented with symptomatic palsy of IX and XII nerves sparing the VII cranial nerve.The patient though later on had internal jugular vein thrombosis,which we presume is due to the involvement of the parapharyngeal space that prompted us to reconsider the diagnosis,and later on,to aggravate the therapy.With proper blood sugar control and appropriate long term antibiotics,not only that the patient is disease free at one year follow up,but the cranial nerve deficits also recovered.Apart from sharing the clinical and management details of this patient,we have reviewed the relevant literature in the discussion,which has shed some light onto some of the interesting facts about this condition and its prognosis.
文摘Godtfredsen syndrome or clival syndrome is a rare syndrome of abducens and hypoglossal nerve palsies (cranial nerve 6th and 12th respectively) that localizes to a clival mass. There are few reported cases of this clinical presentation. The aim of this case report is to describe this rare manifestation observed in a woman with clival metastases arising from a thymoma. A previously well 34-year-old native lady presented to a district hospital in Sabah, Malaysia, with history of blurring of vision and headache for 1 month. Cranial nerve examination reveals right abducens nerve palsy (right 6th CN) and right hypoglossal nerve palsy (right 12th CN). Initial imaging with CT brain reveals a subtle extra-axial hyperdense mass adjacent to the clivus and a routine chest x-ray reveals a mediastinal mass. Further imaging of thorax showed right anterior mediastinal mass, which then proceeded with Video-Assisted Thoracoscopic Surgery (VATS) guided biopsy. The biopsy result was consistent with the finding of thymoma, type B2. She was then diagnosed with aggressive form of thymoma, which unfortunately has metastasized to the bone, lung, liver and brain. Despite prognosis at the time of diagnosis is guarded, she still opted to undergo chemotherapy. Despite the completion of 6 cycles of chemotherapy, her disease progressed, and she eventually succumbed to the illness. In short, the presence of combined 6th and 12th palsy should alert clinician to the possibility of clival mass or metastases and hence could earlier workup with appropriate imaging can lead to earlier diagnosis and better treatment outcome.
