Varicella zoster virus (VZV) infection in the head and neck may manifest as various clinical symptoms and signs which depend on the combination of involved multiple cranial nerves. Involvements of cranial nerve IX and X by VZV are very rare compared to cranial nerve V, VII, and VIII. We present a case of VZV infection of multiple mucosal erosions in the pharynx and larynx, which was confined to the left side without any associated motor dysfunction. VZV infection was confirmed by polymerase chain reaction on the eruptional mucosal lesions and blood. The patient was treated with an antiviral agent, leading to a complete recovery of multiple mucosal lesions after 2 weeks without any sequela.
Chickenpox* ; Cranial Nerves ; Glossopharyngeal Nerve ; Head ; Herpesvirus 3, Human* ; Humans ; Larynx* ; Neck ; Pharynx* ; Polymerase Chain Reaction ; Trigeminal Nerve ; Vagus Nerve ; Vocal Cord Paralysis* ; Vocal Cords*

Ramsay Hunt syndrome (RHS) is characterized by herpes zoster oticus, facial nerve palsy, and vestibulocochlear symptoms. Dysphagia caused by the involvement of multiple cranial nerves (CNs) in RHS is very rare. We encountered a rare case presented with severe dysphagia due to cranial polyneuropathy involving trigeminal nerve (CN V), facial nerve (CN VII), vestibulocochlear nerve (CN VIII), glossopharyngeal nerve (CN IX), vagus nerve (CN X), and hypoglossal nerve (CN XII) in RHS. This case report suggested that the prognosis for dysphagia in RHS seems favorable, and swallowing rehabilitation therapy could be beneficial in expediting tube removal.
Cranial Nerves ; Deglutition ; Deglutition Disorders* ; Facial Nerve ; Glossopharyngeal Nerve ; Herpes Zoster Oticus* ; Hypoglossal Nerve ; Paralysis ; Polyneuropathies* ; Prognosis ; Rehabilitation ; Trigeminal Nerve ; Vagus Nerve ; Vestibulocochlear Nerve

OBJECTIVE: We present our experience of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) and evaluate the postoperative outcomes in accordance with four different operative techniques during MVD. METHODS: In total, 30 patients with intractable primary typical GPN who underwent MVD without rhizotomy and were followed for more than 2 years were included in the analysis. Each MVD was performed using one of four different surgical techniques: interposition of Teflon pieces, transposition of offending vessels using Teflon pieces, transposition of offending vessels using a fibrin-glue-coated Teflon sling, and removal of offending veins. RESULTS: The posterior inferior cerebellar artery was responsible for neurovascular compression in 27 of 30 (90%) patients, either by itself or in combination with other vessels. The location of compression on the glossopharyngeal nerve varied; the root entry zone (REZ) only (63.3%) was most common, followed by both the REZ and distal portion (26.7%) and the distal portion alone (10.0%). In terms of detailed surgical techniques during MVD, the offending vessels were transposed in 24 (80%) patients, either using additional insulation, offered by Teflon pieces (15 patients), or using a fibrin glue-coated Teflon sling (9 patients). Simple insertion of Teflon pieces and removal of a small vein were also performed in five and one patient, respectively. During the 2 years following MVD, 29 of 30 (96.7%) patients were asymptomatic or experienced only occasional pain that did not require medication. Temporary hemodynamic instability occurred in two patients during MVD, and seven patients experienced transient postoperative complications. Neither persistent morbidity nor mortality was reported. CONCLUSION: This study demonstrates that MVD without rhizotomy is a safe and effective treatment option for GPN.
Arteries ; Fibrin ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases* ; Hemodynamics ; Humans ; Microvascular Decompression Surgery* ; Mortality ; Neuralgia ; Polytetrafluoroethylene ; Postoperative Complications ; Rhizotomy ; Veins

We report a 57-year-old man with bilateral cranial nerve IX and X palsies who presented with severe dysphagia. After a mild head injury, the patient complained of difficult swallowing. Physical examination revealed normal tongue motion and no uvular deviation. Cervical X-ray findings were negative, but a brain computed tomography revealed a skull fracture involving bilateral jugular foramen. Laryngoscopy indicated bilateral vocal cord palsy. In a videofluoroscopic swallowing study, food residue remained in the vallecula and pyriform sinus, and there was reduced motion of the pharynx and larynx. Electromyography confirmed bilateral superior and recurrent laryngeal neuropathy.
Brain ; Brain Injuries* ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Deglutition ; Deglutition Disorders ; Electromyography ; Glossopharyngeal Nerve ; Humans ; Laryngoscopy ; Larynx ; Middle Aged ; Paralysis* ; Pharynx ; Physical Examination ; Pyriform Sinus ; Skull Fracture, Basilar ; Skull Fractures ; Tongue ; Vocal Cord Paralysis

The sensor of the taste is the taste bud. The signals originated from the taste buds are transmitted to the central nervous system through the gustatory taste nerves. The chorda tympani nerve (innervating the taste buds of the anterior tongue) and glossopharyngeal nerve (innervating the taste buds of the posterior tongue) are the two primary gustatory nerves. The injuries of gustatory nerves cause their innervating taste buds atrophy, degenerate and disappear. The related taste function is also impaired. The impaired taste function can be restored after the gustatory nerves regeneration. The rat model of cross-regeneration of gustatory nerves is an important platform for research in the plasticity of the central nervous system. The animal behavioral responses and the electrophysiological properties of the gustatory nerves have changed a lot after the cross-regeneration of the gustatory nerves. The effects of the injury, regeneration and cross-regeneration of the gustatory nerves on the taste function in the animals will be discussed in this review. The prospective studies on the animal model of cross-regeneration of gustatory nerves are also discussed in this review. The study on the injury, regeneration and cross-regeneration of the gustatory nerves not only benefits the understanding of mechanism for neural plasticity in gustatory nervous system, but also will provide theoretical basis and new ideas for seeking methods and techniques to cure dysgeusia.
Animals ; Chorda Tympani Nerve ; physiology ; Glossopharyngeal Nerve ; physiology ; Nerve Regeneration ; Neuronal Plasticity ; Rats ; Taste ; physiology ; Taste Buds ; physiology ; Tongue ; innervation

Acupuncture Points ; Acupuncture Therapy ; Female ; Glossopharyngeal Nerve Diseases ; therapy ; Humans ; Middle Aged ; Treatment Outcome

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass (2x3x3 mm in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.
Arteries ; Cranial Nerves ; Female ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases* ; Hemifacial Spasm ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Microvascular Decompression Surgery ; Middle Aged ; Neuralgia ; Pharynx ; Pica ; Trigeminal Neuralgia

No abstract available.
Carcinoma, Squamous Cell* ; Glossopharyngeal Nerve Diseases* ; Tongue Neoplasms ; Tongue*

BACKGROUND AND OBJECTIVES: The aim of the study was to compare the gustatory function between age-matched men and women in Korean subjects. SUBJECTS AND METHOD: Healthy non-smoking volunteers without smell and taste disorders were investigated. Thirty-nine men and women of the same age group were evaluated for gustatory function. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. The electrical taste thresholds were measured using an electrogustometer for four different sites in the oral cavity, i.e., both sides of anterior and posterior tongue. RESULTS: Female subjects had lower mean values of detection and recognition thresholds for all of the four tastes than male subjects, although these results did not reach statistical significance except for the detection threshold for salt and the recognition threshold for quinine. In electrogustometry, thresholds in the posterior tongue of glossopharyngeal nerve area were significantly higher for men than women. CONCLUSION: Men had higher taste threshold than women of the same age category. For additional information on the effects of gender and aging on taste thresholds, further studies including a large number of well-controlled subjects are essential.
Aging ; Citric Acid ; Female ; Glossopharyngeal Nerve ; Humans ; Male ; Mouth ; Quinine ; Smell ; Sodium Chloride ; Sucrose ; Taste Disorders ; Taste Threshold* ; Tongue ; Volunteers

Acupuncture Therapy ; Aged, 80 and over ; Glossopharyngeal Nerve Diseases ; therapy ; Humans ; Male