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At least 19 recordsLinked to original sources
PubMed1999

The glossopharyngeal nerve, glossopharyngeal neuralgia and the Eagle's syndrome--current concepts and management.

Glossopharyngeal neuralgia is not just a painful condition. At times, it may be life-threatening as a result of associated cardiovascular consequences. Even in the absence of life-threatening consequences, it can be a severe debilitating disease with depression, suicidal tendencies, fear of swallowing, loss of weight and under-nutrition. The treatment for glossopharyngeal neuralgia and Eagle's syndrome has evolved over time. This review summarises the scientific evidence and philosophy about current management and therapy. Emphasis is placed on the importance of excluding secondary causes of glossopharyngeal neuralgia before embarking on nerve section through the posterior cranial fossa approach. The Eagle's syndrome due to an elongated styloid process is the most important cause of secondary glossopharyngeal neuralgia. Stylectomy is effective and should be considered before embarking on any neurosurgical procedure. Peripheral cervical and trans-tonsillar approaches to the glossopharyngeal nerve are also discussed.

Cranial Fossa, Posterior↗
PubMed1990

[Selective percutaneous thermocoagulation of the glossopharyngeal nerve in intractable glossopharyngeal neuralgia].

Percutaneous radiofrequency thermocoagulation of glossopharyngeal nerve at the jugular foramen was employed for the treatment of intractable glossopharyngeal neuralgia in three cases, one with essential and two with symptomatic pain from malignant tumor of the oropharyngeal area. Under radiological control, the thermocoagulation electrode was inserted through the lateral cervical route, and the electrode reached the jugular foramen with the tip toward the pars nervosa. The correct position of the electrode was confirmed by radiography and by electrophysiological stimulation test. Once the electrode was properly positioned, lesion was made with temperature of 60 degrees C to 70 degrees C for 1 approximately 2 minutes. Surgical results were satisfactory and no neurological and cardiovascular complications were noted. Percutaneous radiofrequency thermocoagulation of glossopharyngeal nerve is thought to be very useful for the treatment of intractable glossopharyngeal neuralgia.

Adult↗
PubMed2004

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

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.

Cerebellopontine Angle↗
PubMed1996

Choroid plexus compression of glossopharyngeal nerve in patients with glossopharyngeal neuralgia.

Compression of the glossopharyngeal nerve by the lateral choroid plexus of the 4th ventricle protruding excessively through the foramen of Luschka may be at the basis of some forms of glossopharyngeal neuralgia. This condition was observed in four patients. In one case, an anterior compression of the 9th nerve by a megadolic vertebral artery was also present. The condition was resolved in all patients by separating the nerve from the plexus and transecting it at the level of the foramen of Luschka.

Aged↗
PubMed1994

Occurrence of the ventral component of the third branchial nerve as the supernumerary branch of the glossopharyngeal nerve.

The authors found supernumerary branches of the glossopharyngeal nerve in 7 out of 368 head sides (184 bodies) of Japanese individuals. The branches entered the submandibular triangle and connected with the superficial cervical ansa. Teasing revealed that the components of the glossopharyngeal nerve were distributed not only in the subcutaneous layer of the neck but also in the lower facial muscles such as the orbicularis oris. This suggests that the third branchial arch sometimes participates in the formation of the facial muscles which are usually composed of the ventral component of the second branchial arch. Therefore, this supernumerary branch of the glossopharyngeal nerve is probably the ventral component of the third branchial nerve, which is originally distributed in the ventral component of the third branchial arch and usually disappears during later development. The present findings will clearly show how the branchiogenous region is demarcated against the somatic body wall.

Aged↗
PubMed2003

Anatomic landmarks of the glossopharyngeal nerve: a microsurgical anatomic study.

OBJECTIVE: Compared with other lower cranial nerves, the glossopharyngeal nerve (GPhN) is well hidden within the jugular foramen, at the infratemporal fossa, and in the deep layers of the neck. This study aims to disclose the course of the GPhN and point out landmarks to aid in its exposure. METHODS: The GPhN was studied in 10 cadaveric heads (20 sides) injected with colored latex for microsurgical dissection. The specimens were dissected under the surgical microscope. RESULTS: The GPhN can be divided into three portions: cisternal, jugular foramen, and extracranial. The rootlets of the GPhN emerge from the postolivary sulcus and course ventral to the flocculus and choroid plexus of the lateral recess of the fourth ventricle. The nerve then enters the jugular foramen through the uppermost porus (pars nervosa) and is separated from the vagus and accessory nerves by a fibrous crest. The cochlear aqueduct opens to the roof of this porus. On four sides in the cadaver specimens (20%), the GPhN traversed a separate bony canal within the jugular foramen; no separate canal was found in the other cadavers. In all specimens, the Jacobson's (tympanic) nerve emerged from the inferior ganglion of the GPhN, and the Arnold's (auricular branch of the vagus) nerve also consisted of branches from the GPhN. The GPhN exits from the jugular foramen posteromedial to the styloid process and the styloid muscles. The last four cranial nerves and the internal jugular vein pass through a narrow space between the transverse process of the atlas (C1) and the styloid process. The styloid muscles are a pyramid shape, the tip of which is formed by the attachment of the styloid muscles to the styloid process. The GPhN crosses to the anterior side of the stylopharyngeus muscle at the junction of the stylopharyngeus, middle constrictor, and hyoglossal muscles, which are at the base of the pyramid. The middle constrictor muscle forms a wall between the GPhN and the hypoglossal nerve in this region. Then, the GPhN gives off a lingual branch and deepens to innervate the pharyngeal mucosa. CONCLUSION: Two landmarks help to identify the GPhN in the subarachnoid space: the choroid plexus of the lateral recess of the fourth ventricle and the dural entrance porus of the jugular foramen. The opening of the cochlear aqueduct, the mastoid canaliculus, and the inferior tympanic canaliculus are three landmarks of the GPhN within the jugular foramen. Finally, the base of the styloid process, the base of the styloid pyramid, and the transverse process of the atlas serve as three landmarks of the GPhN at the extracranial region in the infratemporal fossa.

Brain Diseases↗
PubMed2001

Non-synaptic transformation of gustatory receptor potential by stimulation of the parasympathetic fiber of the frog glossopharyngeal nerve.

When the glossopharyngeal nerve (GP) in the frog was strongly stimulated electrically, slow potentials were elicited from the tongue surface and taste cells in the fungiform papillae. Injection of atropine completely blocked these slow potentials. The present and previous data indicate that the slow potentials induced in the tongue surface and taste cells are due to a liquid junction potential between saliva secreted from the lingual glands due to parasympathetic fiber activity and an adapting solution on the tongue surface. Intracellularly recorded depolarizing receptor potentials in taste cells induced by 0.5 M NaCl and 3 mM acetic acid were enhanced by depolarizing slow potentials induced by GP nerve stimulation, but were depressed by the hyperpolarizing slow potentials. On average, the receptor potential of taste cells for 0.5 M NaCl was increased by 25% by the GP nerve-induced slow potential, but the receptor potential of taste cells for 3 mM acetic acid was decreased by 1% by the slow potential. These transformations of receptor potentials in frog taste cells were not due to a synaptic event initiated between taste cells and the efferent nerve fiber, but due to a non-synaptic event, a lingual junction potential generated in the dorsal lingual epithelium by GP nerve stimulation.

Animals↗
PubMed1997

Local anesthetic administration for awake direct laryngoscopy. Are glossopharyngeal nerve blocks superior?

BACKGROUND: Glossopharyngeal nerve (GPN) blocks may provide reliable analgesia for awake direct laryngoscopy, although this has not been evaluated prospectively. This study was designed to determine if GPN blocks provide a superior route of local anesthetic administration for awake direct laryngoscopy as measured by hemodynamic, gag, and subjective pain responses. METHODS: A prospective, randomized, single-blinded, crossover design was used. All participants (n = 11) were anesthesiologists. Three routes of local anesthetic administration were evaluated: 2 min of 2% viscous lidocaine swish and gargle (S&G); S&G combined with 10% lidocaine spray (S&G/spray); and S&G combined with 1% lidocaine bilateral GPN blocks (S&G/block; anterior tonsillar pillar method). Five minutes after the local anesthetic was administered, laryngoscopy was performed and sustained for 20 s. Noninvasive hemodynamic measurements and serum lidocaine concentrations were determined. Visual analogue scale scores and a poststudy questionnaire were used to assess participants' ability to tolerate local anesthetic administration and laryngoscopy and their choice for use in clinical practice. RESULTS: No significant hemodynamic changes were observed, although there was a modest increase (< 15%) in heart rate in the S&G/block group in the first minute after laryngoscopy. Serum lidocaine concentrations were higher (P < 0.05) in the S&G/block group at 5 and 10 min (0.5 +/- 0.1 and 1.0 +/- 0.2 microgram/ml) compared with the S&G group. Participants' visual analogue scale scores, which assessed their ability to tolerate laryngoscopy, showed that S&G (5.4 +/- 0.9) resulted in more discomfort (P < 0.05) than either S&G/spray (3.5 +/- 0.9) or S&G/block (3.3 +/- 0.7). The laryngoscopist's visual analogue scale scores, which assessed the ease of visualization, revealed a trend (P < 0.08) toward less coughing and gagging with S&G/spray (1.8 +/- 0.9) compared with S&G (4.0 +/- 1.3) and S&G/block (3.7 +/- 1.1). Oropharyngeal discomfort lasting 24 h or more was reported by 91% of participants after S&G/block, whereas no participant reported oropharyngeal discomfort after S&G or S&G/spray. Significantly more participants (73%) indicated their preference for using S&G/spray in future clinical practice compared with S&G (P < 0.01) and S&G/block (P < 0.05). CONCLUSIONS: Glossopharyngeal nerve blocks do not provide a superior route of local anesthetic administration for awake direct laryngoscopy. Two minutes of 2% viscous lidocaine S&G followed by 10% lidocaine spray was the anesthetic route preferred by participants and laryngoscopists.

Anesthetics, Local↗
PubMed2002

Fully endoscopic vascular decompression of the glossopharyngeal nerve.

Microvascular decompression of the glossopharyngeal nerve is an effective treatment of patients with glossopharyngeal neuralgia in whom compression of the nerve by a blood vessel is implicated in the pathogenesis of the disease. The standard surgical technique uses a binocular operating microscope for intra-operative visualization. Growing experience with posterior fossa endoscopy, however, has suggested that endoscopes may provide more comprehensive anatomical views of cerebellopontine angle. This report describes the case of a patient suffering from glossopharyngeal neuralgia who underwent fully endoscopic vascular decompression of the glossopharyngeal nerve. During this procedure the endoscope was used to survey the posterior fossa, guide the placement of insulating sponges, and conduct a final assessment of the intervention. We found the endoscope ideally suited to the constricted operating space of the posterior fossa, allowing for accurate localization and careful separation of the pathological vascular conflict with minimal brain retraction and no damage to surrounding structures. The versatility of endoscopy allows for superior visual appreciation of neurovascular conflicts in the posterior fossa. To date, endoscopy has primarily been used to supplement microscopy in cranial nerve decompression surgery. This report demonstrates how the endoscope can be used as the sole imaging modality in glossopharyngeal nerve decompression, with excellent results.

Adult↗
PubMed2000

On a complex anastomosis of the glossopharyngeal nerve in humans.

The glossopharyngeal nerve shows anastomoses with the facial nerve and the sympathetic nervous system. One anastomosis extends from the interconnected stylopharyngeal branches, immediately after having perforated the muscle towards the base of skull. Cranially, varying targets of the ascending nerve can be discriminated: 1) The temporal bone. 2) The facial nerve. 3) The sympathetic nerve plexus of the internal carotid nerve. This complex anastomosis was now studied under the dissecting microscope in more detail. The investigation revealed a more complicated distribution pattern of the anastomotic nerve than previously assumed, i.e. the existence of a solitary ascending branch could only be proved in a minority of cases (seven of twenty individuals). In the majority, a delicate nerve plexus could be visualized (thirteen of twenty individuals). In the cases of an anastomosis with the facial nerve, the stylohyoid branch was observed to be the main target of the ascending nerve. Also, connections with the internal carotid nerve were seen. In addition, delicate endings of the branches were demonstrated ramifying in the styloid process or penetrating the temporal bone at other sites. The histological demonstration of ganglion cells within the ascending nerve or nerve plexus suggests parasympathetic and sensoric functions for this anastomosis.

Facial Nerve↗
PubMed2002

Glossopharyngeal nerve evoked potentials after stimulation of the posterior part of the tongue in dogs.

OBJECTIVE: Lower cranial nerve palsy is one of the most critical complications after posterior fossa surgery. However, no established monitoring procedures exist for glossopharyngeal nerve function. Therefore, glossopharyngeal nerve evoked potentials after stimulation of the posterior part of the tongue in dogs was studied to analyze whether glossopharyngeal nerve compound action potentials and evoked potentials are useful in the intraoperative monitoring of patients undergoing brainstem and cerebellopontine angle surgery. METHODS: Glossopharyngeal nerve action potentials and cortical potentials were evoked by stimulating the posterior part of the tongue in mongrel dogs. The potentials were evoked by supramaximal constant current electrical stimuli delivered with bipolar stainless steel needle electrodes and recorded with silver ball electrodes. RESULTS: Compound nerve action potentials were recorded from the exposed intracranial portion of the glossopharyngeal nerve. The latency of the initial negative peak of the action potentials was 2.8 +/- 0.6 milliseconds (mean +/- standard deviation; n = 17). Evoked cortical potentials were recorded on the coronal gyrus by stimulating the contralateral side. The latencies of the initial positive peak and negative peak were 20.1 +/- 3.7 and 35.7 +/- 8.2 milliseconds, respectively (n = 6). Ipsilateral tongue stimulation elicited biphasic evoked potentials on the coronal gyrus, which had small amplitudes and delayed latencies. Both compound nerve action potentials and cortical evoked potentials disappeared after sectioning of the glossopharyngeal nerve. CONCLUSION: The glossopharyngeal nerve action potentials and cortical potentials elicited by the stimulation of the posterior one-third of the tongue can be recorded. These evoked potentials represent a new means for intraoperative monitoring of patients undergoing surgery in the brainstem via the cerebellopontine angle, which involves the lower cranial nerves.

Action Potentials↗
PubMed1991

Parasympathetic postganglionic cells in the glossopharyngeal nerve trunk and their relationship to unmyelinated nerve fibers in the fungiform papillae of the frog.

The glossopharyngeal nerve of the frog is made up of afferent nerve fibers and efferent, parasympathetic and sympathetic nerve fibers. The precise origin and course of the parasympathetic efferent nerve fibers in the fungiform papillae of the frog's tongue were investigated. We found the ganglionic cells in the lingual branch of the frog glossopharyngeal nerve. The surface of the ganglionic cell bodies was partly covered by synaptic endings that impinged upon it. Synaptic endings contained clear synaptic vesicles and large dense-cored vesicles. After cutting of the glossopharyngeal nerve proximal to the jugular ganglion, synaptic endings were found to show definite signs of degeneration. These findings led us to the conclusion that the ganglionic cells in the lingual branch of the glossopharyngeal nerve are the parasympathetic postganglionic cells. After cutting of the glossopharyngeal nerve distal to the jugular ganglion, some unmyelinated nerve fibers in the fungiform papillae and postganglionic cells in the lingual branch remained intact. These results strongly suggest that the origin of some of the unmyelinated nerve fibers is the parasympathetic postganglionic cell in the lingual branch.

Animals↗
PubMed2005

The effect of bilateral glossopharyngeal nerve anaesthesia on swallowing in horses.

REASONS FOR PERFORMING STUDY: Dysfunction of the glossopharyngeal nerve has been implicated as a cause of dysphagia in horses. However, recent studies have indicated that this is not the case. OBJECTIVES: To determine whether bilateral glossopharyngeal nerve anaesthesia would cause dysphagia in horses or result in measurable alterations in the timing, function, or sequence of swallowing. METHODS: Swallowing was evaluated in 6 normal horses with and without bilateral glossopharyngeal nerve anaesthesia. Swallowing dynamics were assessed subjectively and objectively based on time from prehension of food until swallowing, number of tongue movements until initiation of swallowing, depth of bolus at the base of the tongue prior to initiation of swallow and evidence of tracheal aspiration using fluoroscopy and endoscopy. RESULTS: There was no evidence of aspiration or dysphagia in horses before or after bilateral glossopharyngeal nerve block. No observed or measured differences in swallowing sequence or function could be detected in blocked compared to unblocked horses. However, there was a trend in blocked horses for the number of tongue pushes and the time to swallowing to be increased. CONCLUSIONS: Glossopharyngeal nerve function may not be essential for normal swallowing function in otherwise healthy horses. POTENTIAL RELEVANCE: Clinically, normal swallowing is not an appropriate test of glossopharyngeal nerve function and dysphagic horses should not be assumed to have glossopharyngeal nerve dysfunction.

Animals↗
PubMed2000

The taste of ethanol in a primate model. II. Glossopharyngeal nerve response in Macaca mulatta.

The glossopharyngeal nerve (NG) mediates taste from the posterior part of the tongue. Here, we studied the effects of ethanol on the tongue in recordings from both the whole NG and individual taste fibers of the rhesus monkey, Macaca mulatta. The results show that the nerve activity increased at 0.7 M ethanol, reaching half maximum at around 4 M alcohol. Previously, we identified three types of taste fibers in the rhesus monkey NG: S fibers predominantly responding to sweeteners, Q fibers responding to bitter, such as quinine hydrochloride (QHCl), and M fibers responding best to monosodium glutamate, NaCl and acids [Hellekant, G., Danilova, V., & Ninomiya, Y. (1997). Primate sense of taste: behavioral and single chorda tympani and glossopharyngeal nerve fiber recordings in the rhesus monkey, Macaca mulatta. J Neurophysiol 77, 978-993]. Here, this fiber classification was used to elucidate the oral effects of ethanol and ethanol mixtures with NaCl, sucrose, citric acid and QHCl. One and three molar concentrations of ethanol stimulated all fiber types. Mixtures of ethanol with QHCl elicited a smaller response in Q fibers than did QHCl alone. In S fibers, mixtures of ethanol with sucrose gave a larger response than did sucrose alone. The variability of M fibers was too large to allow a conclusion about the effect of ethanol. These results suggest that ethanol suppresses the taste of QHCl. Similarly, the taste of sucrose might be enhanced by adding ethanol to sucrose. These effects and conclusions corroborate an earlier ethanol study of the chorda tympani (CT) nerve [Hellekant, G., Danilova, V., Roberts, T., & Ninomiya, Y. (1997). The taste of ethanol in a primate model: I. Chorda tympani nerve response in Macaca mulatta. Alcohol 14, 473-484].

Analgesics, Non-Narcotic↗