Pathologic Conditions of the Lower Cranial Nerves IX, X, XI, and XII

Policeni, Bruno; Smoker, Wendy R. K.

doi:10.1016/j.nic.2007.12.012

Cited by 23 publications

(51 citation statements)

References 57 publications

(54 reference statements)

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“…Late findings in cranial nerve XII palsy include fatty infiltration of the ipsilateral hemitongue with strict linear demarcation. Muscular atrophy in cranial nerve XII palsy results in tongue deviation toward the healthy contralateral side and posterior bulging of the flaccid paralyzed hemitongue into the oropharynx (94). Late findings in RLN palsy include fatty infiltration of the ipsilateral thyroarytenoid muscle due to atrophy; subsequent enlargement of the ipsilateral ventricle; and piriform sinus and paramedian position of the ipsilateral aryepiglottic fold, false cord, and true vocal cord.…”

Section: Radiation Therapy-induced Brain Necrosis-mentioning

confidence: 99%

“…However, coregistered MR images typically show normal contralateral muscle morphology and help avoid this pitfall (Fig 11). When signs of cranial nerve XII or RLN palsy are seen at MR or PET/MR imaging, the entire nerve course must be scrutinized to detect tumor recurrence (94). In the absence of recurrent disease, radiation therapyinduced nerve paralysis should be considered.…”

Section: Radiation Therapy-induced Brain Necrosis-mentioning

confidence: 99%

See 1 more Smart Citation

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Varoquaux¹,

Rager²,

Dulguerov³

et al. 2015

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Interpreting imaging studies of the irradiated neck constitutes a challenge because of radiation therapy-induced tissue alterations, the variable appearances of recurrent tumors, and functional and metabolic phenomena that mimic disease. Therefore, morphologic magnetic resonance (MR) imaging, diffusion-weighted (DW) imaging, positron emission tomography with computed tomography (PET/CT), and software fusion of PET and MR imaging data sets are increasingly used to facilitate diagnosis in clinical practice. Because MR imaging and PET often yield complementary information, PET/MR imaging holds promise to facilitate differentiation of tumor recurrence from radiation therapy-induced changes and complications. This review focuses on clinical applications of DW and PET/MR imaging in the irradiated neck and discusses the added value of multiparametric imaging to solve diagnostic dilemmas. Radiologists should understand key features of radiation therapy-induced tissue alterations and potential complications seen at DW and PET/MR imaging, including edema, fibrosis, scar tissue, soft-tissue necrosis, bone and cartilage necrosis, cranial nerve palsy, and radiation therapy-induced arteriosclerosis, brain necrosis, and thyroid disorders. DW and PET/MR imaging also play a complementary role in detection of residual and recurrent disease. Interpretation pitfalls due to technical, functional, and metabolic phenomena should be recognized and avoided. Familiarity with DW and PET/MR imaging features of expected findings, potential complications, and treatment failure after radiation therapy increases diagnostic confidence when interpreting images of the irradiated neck. Online supplemental material is available for this article.

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Section: Radiation Therapy-induced Brain Necrosis-mentioning

confidence: 99%

Section: Radiation Therapy-induced Brain Necrosis-mentioning

confidence: 99%

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Varoquaux¹,

Rager²,

Dulguerov³

et al. 2015

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“…The vagus nerve originates from the nucleus ambiguous, exits the medulla, crosses the perimedullary cistern, and leaves the skull base though the pars vasularis of the jugular foramen anterior to the jugular vein. [467] The inferior/nodose ganglion of the vagus nerve, located immediately inferior to the jugular foramen, gives rise to the superior laryngeal nerve that divides into the internal laryngeal nerve (which provides sensory innervation to the larynx above the vocal folds) and the external laryngeal nerve that innervates the cricothyroid muscle. [467] More recent evidence points to extensive terminal arborization of both the recurrent and superior laryngeal nerves, leading to variable contralateral innervation.…”

Section: Anatomymentioning

confidence: 99%

Losing Your Voice: Etiologies and Imaging Features of Vocal Fold Paralysis

et al. 2013

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Neurogenic compromise of vocal fold function exists along a continuum encompassing vocal cord hypomobility (paresis) to vocal fold immobility (paralysis) with varying degrees and patterns of reinnervation. Vocal fold paralysis (VFP) may result from injury to the vagus or the recurrent laryngeal nerves anywhere along their course from the brainstem to the larynx. In this article, we review the anatomy of the vagus and recurrent laryngeal nerves and examine the various etiologies of VFP. Selected cases are presented with discussion of key imaging features of VFP including radiologic findings specific to central vagal neuropathy and peripheral recurrent nerve paralysis.

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“…In the jugular area they arise from paraganglia surrounding the jugular bulb, Arnold's nerve or Jacobson's nerve, a branch of cranial nerve IX. 8,9 Most of these paragangliomas are discovered in an advanced stage with tinnitus, pain and multiple cranial nerve deficits (IX, X, XI) because a significant portion of the jugular foramen is already involved. However, small jugular paragangliomas touching only the jugular ganglion and the nerve of Arnold may present with pain that radiates into the external auditory canal and the TMJ only, as in the patient presented.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 While CT may demonstrate typical irregular erosions of the jugular foramen in large lesions, MR imaging typically depicts a soft-tissue mass with-if the lesion is large enough-a ''salt and pepper appearance''. While ''salt'' represents slow flow and haemorrhage, ''pepper'' corresponds to flow voids from large vessels within the mass.…”

Section: Discussionmentioning

confidence: 99%

¹⁸F-DOPA PET/CT unravels malignant paraganglioma mimicking temporomandibular joint disorder

Terzic

Becker²,

Wissmeyer³

et al. 2011

Dentomaxillofacial Radiology

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This report presents a 29-year-old patient with severe temporomandibular joint (TMJ) pain. Anamnesis and clinical examination led us to the diagnosis of TMJ disorder. He was also in control for a malignant paraganglioma originating from the right carotid body. After initial surgery 8.5 years ago and the removal of metastases 2 years ago he was deemed disease free. An 18 F-3,4-dihydroxyphenylalanine (DOPA) positron emission tomography (PET)/CT scan was obtained during follow-up 6 months before he was presented to our clinic. Suspicious of a connection between the actual pain and the tumour, we scrutinized these images. We found a tiny pathological tracer uptake in the right jugular foramen but no correlating finding in the matching CT. We repeated the DOPA PET/CT and found several metastases including the previously detected lesion. Further thin-slice CT and MRI showed a 5 mm paraganglioma located anteriorly to the jugular bulb within the jugular foramen. The lesion was in close relation to the Arnold's nerve, a branch of the vagus nerve which carries sensory information from the external tympanic membrane, external auditory canal and the external ear and explained the severe pain in our patient. He then underwent radiotherapy (45 Gy) during which the pain diminished considerably. In a variety of neuroendocrine tumours, including paraganglioma, DOPA PET/CT allows primary diagnosis, staging and restaging with a higher detection rate than conventional radiological imaging. Owing to low anatomical resolution however, high resolution contrast-enhanced CT and MRI are necessary to complete the investigations. Dentomaxillofacial Radiology (2011) 40, 315-319. doi: 10.1259/dmfr/22707693 Keywords: malignant paraganglioma; temporomandibular joint disorder; DOPA PET/CT Case reportOur colleagues from the otolaryngology department presented us a 29-year-old patient with severe rightsided temporomandibular joint (TMJ) pain. It had started approximately 1 year earlier and the patient had previously consulted several specialists unsuccessfully. On a visual analogue scale, pain intensity was ten out of ten and required oral medication with morphine. The intraoral examination was normal except for considerable tenderness of all insertions of the muscles of mastication and marked tooth abrasions. Extraorally there was mild bilateral pain on palpation of temporal, masseteric and medial pterygoid muscles and sharp pain on both TMJs. There was no clicking present, no lumps and no asymmetries. A panoramic radiograph was normal. Having seen a faint scar approximately 10 cm long along the anterior part of the right sternocleidomastoid muscle, we resumed our questions. This revealed that the patient underwent surgery for a hereditary paraganglioma (mutation of the genes for succinate dehydrogenase subunit D (SDHD)) of the right carotid body 8.5 years ago. He was well until 2 years ago when paroxysmal blood pressure elevation with concomitant headache occurred. A 24 h blood pressure measurement showed peaks up to 161/ 113 mmHg and tachycard...

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Pathologic Conditions of the Lower Cranial Nerves IX, X, XI, and XII

Cited by 23 publications

References 57 publications

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Losing Your Voice: Etiologies and Imaging Features of Vocal Fold Paralysis

¹⁸F-DOPA PET/CT unravels malignant paraganglioma mimicking temporomandibular joint disorder

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Pathologic Conditions of the Lower Cranial Nerves IX, X, XI, and XII

Cited by 23 publications

References 57 publications

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors

Losing Your Voice: Etiologies and Imaging Features of Vocal Fold Paralysis

18F-DOPA PET/CT unravels malignant paraganglioma mimicking temporomandibular joint disorder

Contact Info

Product

Resources

About

¹⁸F-DOPA PET/CT unravels malignant paraganglioma mimicking temporomandibular joint disorder