Symptoms of glossopharyngeal nerve injury?

summary

The glossopharyngeal nerve is a mixed nerve, which is an important sensory afferent nerve in the glossopharyngeal region. Its motor branches are mainly used to promote the soft palate function, and the parasympathetic fibers are used to secrete the parotid gland. The glossopharyngeal nerve belongs to the posterior cranial nerve. The injury is mostly caused by the fracture line and jugular foramen, but the lesion of jugular foramen in the posterior fossa is easy to cause glossopharyngeal nerve injury. The injury of glossopharyngeal nerve often involves the posterior cranial nerve at the same time. It is manifested as the decrease or disappearance of taste in the posterior 1 / 3 of the affected side, the decrease or loss of upper pharyngeal sensation, and the ptosis of soft palate. So let's understand the symptoms of glossopharyngeal nerve injury??

Symptoms of glossopharyngeal nerve injury?

First, unilateral glossopharyngeal nerve injury showed loss of taste in the posterior third of the tongue on the same side, loss of pain in the root of tongue and pharyngeal isthmus (because of its self sensation, there were no pharyngeal reflex and swallowing reflex disorders), weakness of ipsilateral pharyngeal muscle and obvious parotid gland secretion disorder. When one side of glossopharyngeal nerve, vagus nerve or its nerve nucleus is damaged, ipsilateral soft palate paralysis, hypopesthesia or disappearance of pharynx, disappearance of pharyngeal reflex, cough and hoarseness may occur.

Second: Patients with bilateral glossopharyngeal nerve injury have serious disorders in eating, swallowing, and pronunciation. In severe cases, the soft palate and uvula tend to the contralateral side when the patient makes "ah" sound, and they can't even pronounce, swallow, and saliva flow, which is called true bulbar paralysis.

Third: CT examination of the posterior cranial fossa and skull base can also clearly show the space occupying lesions, especially the skull base bone window and three-dimensional reconstruction technology can clearly show the changes of skull base bone, and can also clearly show the skull line fracture.

matters needing attention

1. Etiological treatment: treat the causes of glossopharyngeal nerve injury, such as inflammation, tumor, vascular disease, etc. Removal of the etiology is an important basis to ensure the recovery of glossopharyngeal nerve function. 2. To promote the recovery of nerve function. For the glossopharyngeal nerve injury or damage caused by trauma, tumor, operation and other pathological changes, conservative treatment is generally adopted. Neurotrophins, vasodilators and steroid hormones are given, such as vitamin B1, vitamin B12, nerve growth factor, brain protein hydrolysate (Cerebrolysin), Dibazol, nimodipine, dexamethasone, etc. 3. Treatment of complications: severe patients with vagus nerve injury may develop pneumonia due to aspiration due to dysphagia. Tracheotomy should be performed in the acute stage if necessary to keep the respiratory tract unobstructed and prevent pneumonia. Some patients have to rely on gastric tube for a long time.