Anatomical Basis of Hypoglossal Nerve Palsy
Surgical and Non-Surgical Management
Hypoglossal nerve palsy affects tongue movement, speech, and swallowing. Understanding its anatomy and management options aids in better clinical decision-making.
Anatomical Basis of Hypoglossal Nerve Palsy
Surgical and Non-Surgical Management
The hypoglossal nerve (cranial nerve XII) is responsible for motor innervation to the tongue muscles. Hypoglossal nerve palsy leads to tongue weakness, atrophy, and deviation, affecting speech and swallowing.
Anatomical Basis
The hypoglossal nerve originates from the medulla oblongata and exits the skull via the hypoglossal canal. It courses through the neck, interacting with other neurovascular structures, making it vulnerable to injury.
Etiology
- Trauma (surgical or accidental)
- Neoplastic compression
- Vascular anomalies
- Inflammatory or infectious diseases
- Neurodegenerative disorders
Clinical Presentation
Patients with hypoglossal nerve palsy exhibit tongue deviation to the affected side, muscle atrophy, and dysarthria. Bilateral involvement can lead to severe dysphagia.
Diagnostic Approach
- Neurological examination
- Imaging (MRI, CT)
- Electromyography (EMG)
Management Strategies
Non-Surgical Management
- Physical therapy
- Speech therapy
- Medical management of underlying conditions
Surgical Management
- Decompression surgery for tumors or vascular anomalies
- Reconstructive nerve grafting
- Hypoglossal-facial nerve anastomosis in severe cases
Prognosis
Recovery depends on the etiology and treatment approach. Early intervention leads to better functional outcomes.
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