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Review
. 2024 Apr 14;12(4):864.
doi: 10.3390/biomedicines12040864.

Hypoglossal Nerve Neuropathies-Analysis of Causes and Anatomical Background

Andrzej Węgiel  1 , Nicol Zielinska  1 , Mariola Głowacka  2 , Łukasz Olewnik  3
Affiliations
Review

Hypoglossal Nerve Neuropathies-Analysis of Causes and Anatomical Background

Andrzej Węgiel et al. Biomedicines. .

Abstract

The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

Keywords: compression; hypoglossal nerve; iatrogenic; internal carotid artery; neuropathy; palsy; paralysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of the HN and the ansa cervicalis branches.
Figure 2
Figure 2
Segments of the HN: ICA internal carotid artery, CAS canalar segment, CS cisternal segment, DS descending segment, AC ansa cervicalis, BIM branches to infrahyoid muscles, HB hyoid bone, SS sublingual segment.
Figure 3
Figure 3
Relations between the HN and the adjacent arteries: XI accessory nerve, VA vertebral artery, PICA posterior inferior cerebellar artery, IX and X rootlets of vagus and glossopharyngeal nerves, HN hypoglossal nerve, VI abducens nerve, AICA anterior inferior cerebellar artery, VII facial nerve, VIII vestibulocochlear nerve.
Figure 4
Figure 4
The HN and the adjacent vessels STRB upper and lower sternocleidomastoid branches.
Figure 5
Figure 5
Compression of the HN by an osteophyte based on Patro et al. [130].
See this image and copyright information in PMC

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