Neurophysiological Intraoperative Monitoring of the Glossopharyngeal Nerve: Technical Case Report

2008 ◽  
Vol 63 (suppl_4) ◽  
pp. ONSE277-ONSE278 ◽  
Author(s):  
Aatif M. Husain ◽  
David R. Wright ◽  
Bret W. Stolp ◽  
Allan H. Friedman ◽  
John C. Keifer
Keyword(s):  
Vagus Nerve ◽  
Intraoperative Monitoring ◽  
Cranial Nerves ◽  
Glossopharyngeal Nerve ◽  
Vagus Nerves ◽  
Nerve Monitoring ◽  
Adhesive Surface ◽  
Pharyngeal Muscles ◽  
Swallowing Difficulty ◽  
Lower Cranial Nerves

Abstract Objective: Neurophysiological intraoperative monitoring of the glossopharyngeal nerve has been performed only with needle electrodes inserted into the pharyngeal muscles or soft palate. We describe a noninvasive method of monitoring this cranial nerve. Methods: A 30-year-old man who presented with headache, as well as speech and swallowing difficulty, underwent surgical resection of a right vagus nerve schwannoma. Neurophysiological intraoperative monitoring of multiple lower cranial nerves, including the glossopharyngeal and vagus nerves, was performed. Results: The glossopharyngeal nerve was monitored with an adhesive surface electrode mounted on the cuff of a laryngeal mask airway, and the vagus nerve was monitored with a similar electrode mounted on the endotracheal tube. Successful monitoring allowed separation of the glossopharyngeal nerve from the tumor, and there was no postoperative swallowing deficit. Conclusion: Monitoring of the glossopharyngeal nerve with surface electrodes is possible and reliable, but it must be combined with vagus nerve monitoring.

scholarly journals The microsurgical anatomy of the glossopharyngeal nerve with respect to the jugular foramen lesions

2004 ◽  
Vol 17 (2) ◽  
pp. 12-21 ◽  
Author(s):  
Mehmet Faik Özveren ◽  
Uđur Türe
Keyword(s):  
Surgical Treatment ◽  
Cranial Nerves ◽  
Jugular Foramen ◽  
Glossopharyngeal Nerve ◽  
Detailed Knowledge ◽  
Microsurgical Anatomy ◽  
Anatomical Landmarks ◽  
Related Area ◽  
Deep Layers ◽  
Lower Cranial Nerves

Removal of lesions involving the jugular foramen region requires detailed knowledge of the anatomy and anatomical landmarks of the related area, especially the lower cranial nerves. The glossopharyngeal nerve courses along the uppermost part of the jugular foramen and is well hidden in the deep layers of the neck, making this nerve is the most difficult one to identify during surgery. It may be involved in various pathological entities along its course. The glossopharyngeal nerve can also be compromised iatrogenically during the surgical treatment of such lesions. The authors define landmarks that can help identify this nerve during surgery and discuss the types of lesions that may involve each portion of the glossopharyngeal nerve.

Carotid body tumors: a subject review and suggested surgical approach

1986 ◽  
Vol 64 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Fredric B. Meyer ◽  
Thoralf M. Sundt ◽  
Bruce W. Pearson
Keyword(s):  
Carotid Body ◽  
Surgical Approach ◽  
Intraoperative Monitoring ◽  
Cranial Nerves ◽  
Surgical Results ◽  
Major Morbidity ◽  
Content Type ◽  
Carotid Body Tumors ◽  
Lower Cranial Nerves ◽  
Fine Print

✓ Carotid body tumors are a rare but potentially difficult surgical entity. Their pathology, physiology, and natural history are reviewed along with surgical results reported in the literature. A surgical approach for removal of these tumors is presented which differs significantly from the recommended techniques in that emphasis is placed on intraoperative monitoring of cerebral blood flow, the selective use of shunts, a tumor-adventitial plane of dissection, preservation of the carotid artery complex, and mobilization of the parotid gland. Thirteen cases using these techniques are reviewed. The mortality rate and the incidence of cerebrovascular sequelae were both 0%. The major morbidity consisted of injury to the lower cranial nerves in five patients (39%) with tumors larger than 5 cm in length.

scholarly journals Further research in the area of the central endings of the X-th pair of cranial nerves

2020 ◽  
Vol VI (2) ◽  
pp. 155-168
Author(s):  
V. P. Osipov
Keyword(s):  
Vagus Nerve ◽  
Medulla Oblongata ◽  
Cranial Nerves ◽  
Vagus Nerves ◽  
The Way

In 1896, I published the research of the central endings of the vagus nerve. Continuing with the study in the indicated direction, I received, in addition to confirming the results of the first study, some results that were not devoid of interest; These results were not new for me, because on the microscopic preparations that served as materials for the first work, there are corresponding changes in the area of ​​the central endings of the vagus nerve; on the contrary, further research was undertaken by me with the aim of checking the constancy of some changes in the medulla oblongata, advancing every step of the way behind the overwhelming vagus nerves. Thus, the present work is, as it were, an addition to the first one, containing the results of research that were not included in the first work.

Effects of sectioning cranial nerves IX and X on the cardiac response to hypoxia in the coho salmon, Oncorhynchus kisutch

1984 ◽  
Vol 62 (5) ◽  
pp. 766-768 ◽  
Author(s):  
Frank M. Smith ◽  
Peter S. Davie
Keyword(s):  
Vagus Nerve ◽  
Surgical Procedures ◽  
Coho Salmon ◽  
Cranial Nerves ◽  
Oncorhynchus Kisutch ◽  
Glossopharyngeal Nerve ◽  
Cardiac Response

We have shown that oxygen receptors located in the first gill arches of coho salmon, and responsible for hypoxic bradycardia, may be innervated by branches of the glossopharyngeal nerve (cranial IX). Bilateral section of these branches produced a reduction in the cardiac response to rapidly induced hypoxia. Branches of the vagus nerve (cranial X) also innervate the first gill arches in salmon; when both vagal and glossopharyngeal branches to the first gill arches were sectioned, hypoxic bradycardia was reduced by the same degree as was observed when the glossopharyngeal branches alone were sectioned. The surgical procedures involved in denervation appeared to have no effect on the cardiac response to hypoxia. The pattern of innervation of oxygen receptors causing hypoxic bradycardia in salmonids is compared with the more diffuse pattern found in elasmobranchs.

scholarly journals Intraoperative Monitoring Methods for the Lower Cranial Nerves

2001 ◽  
Vol 10 (5) ◽  
pp. 330-338
Author(s):  
Kenji Sugiyama ◽  
Tetsuo Yokoyama ◽  
Hiroshi Ryu ◽  
Hiroki Namba
Keyword(s):  
Intraoperative Monitoring ◽  
Cranial Nerves ◽  
Monitoring Methods ◽  
Lower Cranial Nerves

Endonasal access to lower cranial nerves: From foramina to upper parapharyngeal space

Head & Neck ◽  
2021 ◽  
Author(s):  
Lifeng Li ◽  
Nyall R. London ◽  
Daniel M. Prevedello ◽  
Ricardo L. Carrau
Keyword(s):  
Parapharyngeal Space ◽  
Cranial Nerves ◽  
Lower Cranial Nerves

scholarly journals Far Lateral Craniotomy for Resection of Foramen Magnum Meningioma

2019 ◽  
Vol 80 (S 04) ◽  
pp. S355-S357
Author(s):  
Robert T. Wicks ◽  
Xiaochun Zhao ◽  
Celene B. Mulholland ◽  
Peter Nakaji
Keyword(s):  
Cranial Nerves ◽  
Craniocervical Junction ◽  
Foramen Magnum ◽  
Occipital Condyle ◽  
Formidable Challenge ◽  
Close Proximity ◽  
Vertebrobasilar Circulation ◽  
Far Lateral ◽  
Lower Cranial Nerves ◽  
Gain Access

Abstract Objective Foramen magnum meningiomas present a formidable challenge to resection due to frequent involvement of the lower cranial nerves and vertebrobasilar circulation. The video shows the use of a far lateral craniotomy to resect a foramen magnum meningioma. Design, Setting, and Participant A 49-year-old woman presented with neck pain and was found to have a large foramen magnum meningioma (Fig. 1A, B). Drilling of the posterior occipital condyle was required to gain access to the lateral aspect of the brain stem. The amount of occipital condyle resection varies by patient and pathology. Outcome/Result Maximal total resection of the tumor was achieved (Fig. 1B, C), and the patient was discharged on postoperative day 4 with no neurologic deficits. The technique for tumor microdissection (Fig. 2) is shown in the video. Conclusion Given the close proximity of foramen magnum meningiomas to vital structures at the craniocervical junction, surgical resection with careful microdissection and preservation of the overlying dura to prevent postoperative pseudomeningocele is necessary to successfully manage this pathology in those patients who are surgical candidates.The link to the video can be found at: https://youtu.be/Mds9N1x2zE0.

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