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Glossopharyngeal and Hypoglossal Nerve Paralysis Secondary to Prevertebral Phlegmon.

A 50-year-old man introduced to the clinic with extreme neck ache, fever, and issue respiratory and was subsequently admitted to the native orthopedics division with doable retropharyngeal abscess and pyogenic spondylitis. Antibiotic remedy was initiated; nevertheless, as a consequence of poor oxygenation, he was referred and transferred to our division and admitted. Magnetic resonance imaging confirmed sign modifications on the left C1/2 lateral atlantoaxial joint, posterior pharynx, longus colli muscle, carotid area, and medial deep cervical area, predominantly on the left aspect.
As well as, regardless of lymph node enlargement from the posterior pharynx to the deep cervical area, there was no abscess formation. There have been no indicators of a space-occupying lesion or sign modifications within the jugular foramen. Sooner or later postadmission, the affected person’s temperature had risen to 39.1°C and his SpO2 had fallen. His neck ache had additionally worsened, and emergency surgical procedure was determined. Preoperatively, we suspected retropharyngeal abscess and pyogenic spondylitis.
On day 13 postadmission, the affected person exhibited dysphagia, deviated tongue protrusion, and the curtain signal. Glossopharyngeal and hypoglossal nerve paralysis have been identified. The affected person’s swallowing capabilities recovered and he was discharged on day 36. We skilled a case of glossopharyngeal and hypoglossal nerve paralysis secondary to pyogenic cervical aspect joint arthritis.

Percutaneous Pulsed Radiofrequency Therapy in a Affected person with Continual Bilateral Painful Glossopharyngeal Neuropathy.

BACKGROUND Attributable to its rareness, we current a case of persistent, bilateral, painful glossopharyngeal neuropathy, which developed after nasal septum and inferior concha surgical procedure, and was non-surgically handled with percutaneous pulsed radiofrequency on the glossopharyngeal nerve, utilizing an extra-oral strategy. CASE REPORT A 41-year-old Caucasian feminine affected person (60 kg, 1.57 m, physique mass index 24.eight kg/m²) was referred to the Ache Heart by her basic practitioner due to ongoing urgent ache in her throat Four months after nasal septum and inferior concha surgical procedure.
Based mostly upon medical historical past, bodily examination and the outcomes of further questionnaires, a possible analysis of atypical neck ache was made, based mostly on ongoing glossopharyngeal stimulation, involvement of the pterygopalatine ganglion or/and superior cervical ganglion, with secondary involvement of the muscle mass of the neck.
We modified the analgesic routine and carried out a pulsed radiofrequency remedy of the glossopharyngeal nerve on either side. The affected person had made progress and reported that she really felt higher however she requested for repeat remedy due to residual complaints. We carried out the process for a second time on either side. The outcomes of the questionnaires earlier than (T0) remedy, Three months after the primary (T1) and three months after the second (T2) remedy are supplied.
After the second process, the affected person reported that her swallowing complaints had additional diminished, in addition to the ache behind her ears. She stopped utilizing pregabalin. Residual complaints have been manageable. CONCLUSIONS In sufferers with painful glossopharyngeal neuropathy, a non-surgically remedy with percutaneous pulsed radiofrequency on the glossopharyngeal nerve, utilizing an extra-oral strategy, appears to be an efficient and secure technique to make use of.
Glossopharyngeal and Hypoglossal Nerve Paralysis Secondary to Prevertebral Phlegmon.

Research of the Anatomical Options of the Offending Arteries Concerned in Glossopharyngeal Neuralgia.

The anatomic options of the posterior inferior cerebellar arteries (PICAs) and the anterior inferior cerebellar arteries (AICAs) as offending arteries concerned in glossopharyngeal neuralgia (GPN) are vital to dictate the very best surgical strategy.To check and classify the anatomic options of the offending arteries.
All medical knowledge and surgical movies from 18 GPN circumstances that have been surgically handled in the course of the previous 10 yr have been retrospectively reviewed.Amongst these 18 sufferers, the offending arteries concerned have been the PICA in 12 (66.7%), AICA in 4 (22.2%), and each PICA and AICA in 2 (11.1%).
The PICA have been then categorised into the next teams based mostly on their anatomic options: kind I: the PICA fashioned an upward loop on the stage of the glossopharyngeal nerve and handed between the glossopharyngeal and vestibulocochlear nerves; kind II: the PICA fashioned an upward loop on the stage of the glossopharyngeal nerve and handed between the glossopharyngeal and vagus nerves or between the rootlets of the vagus nerve; and sort III: the PICA handed between the glossopharyngeal and vestibulocochlear nerves with out forming a loop. The AICA had just one working sample.The offending arteries concerned in GPN, primarily the PICA and/or AICA, have been categorised into Four differing kinds based mostly on their anatomic options.

The outcomes of a second and third Gamma Knife radiosurgery for recurrent important glossopharyngeal neuralgia.

Gamma Knife radiosurgery (GKR) is a minimally invasive surgical choice for drug-resistant important glossopharyngeal neuralgia (GPN). The authors reviewed ache outcomes and issues in GPN sufferers who underwent a second or a 3rd GKR for recurrent or persistent ache.A retrospective evaluation of all sufferers handled in a single heart (Marseille, France) since 2004 was carried out.
Median prescribed dose was 85 Gy (vary 70-90 Gy) at second GKR and 85 Gy at third GKR. Medical end result was evaluated utilizing the Barrow Neurological Institute (BNI) scale.Six sufferers (Four males, 2 females) underwent second or third GKR. The median age was 70.2 years (vary 64-83 years) at second GKR and 79.eight years at third GKR. No affected person had any earlier surgical procedure however GKR. 5 circumstances had a neurovascular battle. Median follow-up interval was 12 months (vary 10-94 months) after second GKR and 16 months after third GKR.
The median delay to preliminary ache freedom response was 30 days (vary 3-120 days). One affected person skilled pharyngeal hypoesthesia after second GKR. After a 3rd GKR, as much as 16 months, no unwanted side effects have been encountered. On the final follow-up, Three sufferers have been BNI I, 2 have been BNI IIIa, and one didn’t have any enchancment.
Second GKR resulted in ache discount with low threat of further morbidity. In sufferers unsuitable for microvascular decompression, GKR as a repeat or third remedy for intractable GPN is secure and efficient. Third GKR was not related to any unwanted side effects as much as 16 months after the process.
Alexander Sanchez