The Hypoglose Nerve: importance and anatomo-clinical correlation.

Abstract

The hypoglossal nerve, unlike other cranial nerves, is not only a monofascicular afferent nerve that acts on striated muscles, but also participates in vital functions such as breathing, food and speech. This nerve originates in the medulla oblongata crosses the occipital condyle and reaches the lingual muscles. The objective of this study is to classify the trajectory of the nerve in different segments and identify the important anatomical landmark in each segment through which it passes, with special emphasis on those in which the nerve has a strategic role as an objective of accidental injuries or during surgical approaches. In addition, evaluate the ability to resolve pathologies as a potential donor of axons in peripheral nerve pathologies (facial nerve paralysis, recurrent laryngeal nerve, etc.) or as the main axis of neuromodulator treatments, such as apnea / hypopnea obstructive sleep syndrome.
A systematic literature review of anatomical, histological, neurophysiological, radiological, clinical and pathological studies was performed. We also conducted a laboratory study with cadaveric specimen and histological sections. We describe the precise anatomical characteristics of each section with the corresponding anatomo-surgical and radiological correlation. Finally, the discussion focused on the role of the hypoglossal nerve to resolve relevant pathologies such as obstructive sleep apnea syndrome and the resolution of other less frequent but no less important diseases, such as peripheral facial paralysis and inferior laryngeal nerve paralysis.