Hypoglossal Nerve Palsy as a Cause of Severe Dysphagia along with the Oropharyngeal Stenosis due to Occipitocervical Kyphosis

Hypoglossal nerve palsy (HNP) is a potential cause of dysphagia. A 66-year-old man presented to our hospital with dysphagia and neck pain. One year prior to his first visit, he had been diagnosed with upper cervical tuberculosis and had undergone posterior C1-2 fixation. The physical examination led to the diagnosis of dysphagia with HNP, and he had severe weight loss. Radiographic examination revealed that the O-C kyphosis had been exacerbated and that the deformity was likely the primary cause of HNP. To restore the swallowing function, O-C fusion surgery was performed. Postoperatively, the patient showed immediate improvement of dysphagia with gradual recovery of hypoglossal nerve function. In the last follow-up evaluation, swallowing function was confirmed with no signs of HNP. Our results indicate that HNP could be more prevalent in cases with severe cervical kyphosis, being underdiagnosed due to the more apparent signs of the oropharyngeal narrowing.

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Hypoglossal Nerve Palsy As an Initial Presentation of Glomus Jugulare Tumor in Patient with Breast Cancer: A Case Report and Literature Review

Galen Medical Journal ◽

10.31661/gmj.v10i0.2222 ◽

2021 ◽

Vol 10 ◽

pp. e2222

Author(s):

Askar Ghorbani ◽

Vahid Reza Ostovan

Keyword(s):

Breast Cancer ◽

Case Report ◽

Nerve Palsy ◽

Hypoglossal Nerve ◽

Clinical Manifestations ◽

Glomus Jugulare Tumor ◽

Hypoglossal Nerve Palsy ◽

Glomus Jugulare ◽

Work Up

Background: Glomus jugulare tumor is a rare, slow-growing, hyper-vascular paraganglioma that originates from the neural crest derivatives in the wall of the jugular bulb. The most common clinical manifestations of glomus jugulare are pulsatile tinnitus, conductive hearing loss, and hoarseness due to its vascularity and invasion of surrounding structures. Isolated hypoglossal nerve palsy as a presenting feature of the glomus jugulare is very rare. Case Report: We report a 61-year-old woman with a past medical history of breast cancer and diabetic mellitus presenting with progressive difficulty handling food in her mouth and tongue atrophy. Investigations showed skull base lesion and solitary pulmonary nodule. Further work-up led to glomus jugulare and benign solitary pulmonary fibrous tumor diagnosis, although the first impression was metastatic involvement of the jugular foramen. Endovascular embolization of the glomus jugulare was performed, but the patient refused any open surgery due to co-morbidities and the risk of operation. She had no new symptoms at the one-year follow-up, and the size of the lesion became more minor on the follow-up imaging relative to the baseline. Conclusion: Glomus jugulare tumors should be considered and surveyed in the diagnostic work-up of patients with hypoglossal nerve palsy. [GMJ.2021;10:e2222]

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Hypoglossal Nerve Palsy due to Occipito-Cervical Kyphosis: A Case Report

Journal of Neurological Disorders ◽

10.4172/2329-6895.1000379 ◽

2018 ◽

Vol 06 (02) ◽

Author(s):

Tomohiro Watanabe ◽

Masato Anno ◽

Yoshitaka Matsubayashi ◽

Yoh Fujimoto ◽

Naohiro Tachibana ◽

...

Keyword(s):

Case Report ◽

Nerve Palsy ◽

Hypoglossal Nerve ◽

Cervical Kyphosis ◽

Hypoglossal Nerve Palsy

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Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.5.1.83 ◽

2006 ◽

Vol 5 (1) ◽

pp. 83-85 ◽

Cited By ~ 51

Author(s):

Jae Taek Hong ◽

Sang Won Lee ◽

Byung Chul Son ◽

Jae Hoon Sung ◽

Il Sub Kim ◽

...

Keyword(s):

Nerve Palsy ◽

Hypoglossal Nerve ◽

Posterior Instrumentation ◽

Screw Placement ◽

Lateral Mass ◽

Lateral Mass Screw ◽

Hypoglossal Nerve Palsy ◽

Atlantoaxial Fixation ◽

Atlantoaxial Stabilization

✓ Atlantoaxial fixation in which C1–2 screw–rod fixation is performed is a relatively new method. Because reports about this technique are rather scant, little is known about its associated complications. In this report the authors introduce hypoglossal nerve palsy as a complication of this novel posterior atlantoaxial stabilization method. A 67-year-old man underwent a C1–2 screw–rod fixation for persistent neck pain resulting from a Type 2 odontoid fracture that involved disruption of the transverse atlantal ligament. Posterior instrumentation in which a C-1 lateral mass screw and C-2 pedicle screw were placed was performed. Postoperatively, the patient suffered dysphagia with deviation of the tongue to the left side. At the 4-month follow-up examination, bone fusion was noted on plain x-ray studies of the cervical spine. His hypoglossal nerve palsy resolved completely 2 months postoperatively. To the authors’ knowledge, this is the first report in the literature of hypoglossal nerve palsy following C1–2 screw–rod fixation. The hypoglossal nerve is one of the structures that can be damaged during C-1 lateral mass screw placement.

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