Intraoperative and anatomical descriptions of intracranial connections between the glossopharyngeal and vagus nerves

Clinical implications - Laboratory investigation

R. Shane Tubbs, Martin M. Mortazavi, Marios Loukas, Mohammadali Mohajel Shoja, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Object. Knowledge of the variations in the nerves of the posterior cranial fossa may be important during skull base approaches. To the authors' knowledge, intracranial neural interconnections between the glossopharyngeal and vagus nerves have not been previously investigated. Methods. The senior author (A.C.G.) noted the presence of an intracranial interneural connection between the glossopharyngeal and vagus nerves during microvascular decompression surgery in a patient suffering from hemifacial spasm. To further investigate the approximate incidence and significance of such an interneural connection, the authors studied 40 adult human cadavers (80 sides) and prospectively evaluated 16 additional patients during microvascular procedures of the posterior cranial fossa. Results. In the cadavers, the incidence of intracranial neural connections between the glossopharyngeal and vagus nerves was 2.5%. The only such connection found in our series of living patients was in the patient in whom the connection was initially identified. These interconnections were more common on the left side. Based on our findings, we classified these neural connections as Types I and II. In the cadavers, the length and width of this connection were approximately 9 mm and 1 mm, respectively. Histological analysis of these connections verified their neural content. Conclusions. Although these connections are rare and the significance is unknown, knowledge of them may prove useful to surgeons who operate in the posterior fossa region so that they may avoid inadvertent traction or transection of these interconnections. Additionally, such connections might be considered in patients with recalcitrant neuralgia after microvascular decompression and rhizotomy of the glossopharyngeal nerve.

Original languageEnglish (US)
Pages (from-to)179-181
Number of pages3
JournalJournal of Neurosurgery
Volume115
Issue number1
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

Fingerprint

Glossopharyngeal Nerve
Vagus Nerve
Cadaver
Microvascular Decompression Surgery
Posterior Cranial Fossa
Hemifacial Spasm
Rhizotomy
Neural Pathways
Incidence
Skull Base
Traction
Neuralgia

Keywords

  • Anatomy
  • Intracranial connection
  • Neurosurgery
  • Variation

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Clinical Neurology

Cite this

Intraoperative and anatomical descriptions of intracranial connections between the glossopharyngeal and vagus nerves : Clinical implications - Laboratory investigation. / Tubbs, R. Shane; Mortazavi, Martin M.; Loukas, Marios; Mohajel Shoja, Mohammadali; Cohen-Gadol, Aaron A.

In: Journal of Neurosurgery, Vol. 115, No. 1, 01.07.2011, p. 179-181.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Mortazavi, Martin M. ; Loukas, Marios ; Mohajel Shoja, Mohammadali ; Cohen-Gadol, Aaron A. / Intraoperative and anatomical descriptions of intracranial connections between the glossopharyngeal and vagus nerves : Clinical implications - Laboratory investigation. In: Journal of Neurosurgery. 2011 ; Vol. 115, No. 1. pp. 179-181.
@article{4c97cf51c06d4b3c90643e4f507b68de,
title = "Intraoperative and anatomical descriptions of intracranial connections between the glossopharyngeal and vagus nerves: Clinical implications - Laboratory investigation",
abstract = "Object. Knowledge of the variations in the nerves of the posterior cranial fossa may be important during skull base approaches. To the authors' knowledge, intracranial neural interconnections between the glossopharyngeal and vagus nerves have not been previously investigated. Methods. The senior author (A.C.G.) noted the presence of an intracranial interneural connection between the glossopharyngeal and vagus nerves during microvascular decompression surgery in a patient suffering from hemifacial spasm. To further investigate the approximate incidence and significance of such an interneural connection, the authors studied 40 adult human cadavers (80 sides) and prospectively evaluated 16 additional patients during microvascular procedures of the posterior cranial fossa. Results. In the cadavers, the incidence of intracranial neural connections between the glossopharyngeal and vagus nerves was 2.5{\%}. The only such connection found in our series of living patients was in the patient in whom the connection was initially identified. These interconnections were more common on the left side. Based on our findings, we classified these neural connections as Types I and II. In the cadavers, the length and width of this connection were approximately 9 mm and 1 mm, respectively. Histological analysis of these connections verified their neural content. Conclusions. Although these connections are rare and the significance is unknown, knowledge of them may prove useful to surgeons who operate in the posterior fossa region so that they may avoid inadvertent traction or transection of these interconnections. Additionally, such connections might be considered in patients with recalcitrant neuralgia after microvascular decompression and rhizotomy of the glossopharyngeal nerve.",
keywords = "Anatomy, Intracranial connection, Neurosurgery, Variation",
author = "Tubbs, {R. Shane} and Mortazavi, {Martin M.} and Marios Loukas and {Mohajel Shoja}, Mohammadali and Cohen-Gadol, {Aaron A.}",
year = "2011",
month = "7",
day = "1",
doi = "10.3171/2011.2.JNS101757",
language = "English (US)",
volume = "115",
pages = "179--181",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "1",

}

TY - JOUR

T1 - Intraoperative and anatomical descriptions of intracranial connections between the glossopharyngeal and vagus nerves

T2 - Clinical implications - Laboratory investigation

AU - Tubbs, R. Shane

AU - Mortazavi, Martin M.

AU - Loukas, Marios

AU - Mohajel Shoja, Mohammadali

AU - Cohen-Gadol, Aaron A.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Object. Knowledge of the variations in the nerves of the posterior cranial fossa may be important during skull base approaches. To the authors' knowledge, intracranial neural interconnections between the glossopharyngeal and vagus nerves have not been previously investigated. Methods. The senior author (A.C.G.) noted the presence of an intracranial interneural connection between the glossopharyngeal and vagus nerves during microvascular decompression surgery in a patient suffering from hemifacial spasm. To further investigate the approximate incidence and significance of such an interneural connection, the authors studied 40 adult human cadavers (80 sides) and prospectively evaluated 16 additional patients during microvascular procedures of the posterior cranial fossa. Results. In the cadavers, the incidence of intracranial neural connections between the glossopharyngeal and vagus nerves was 2.5%. The only such connection found in our series of living patients was in the patient in whom the connection was initially identified. These interconnections were more common on the left side. Based on our findings, we classified these neural connections as Types I and II. In the cadavers, the length and width of this connection were approximately 9 mm and 1 mm, respectively. Histological analysis of these connections verified their neural content. Conclusions. Although these connections are rare and the significance is unknown, knowledge of them may prove useful to surgeons who operate in the posterior fossa region so that they may avoid inadvertent traction or transection of these interconnections. Additionally, such connections might be considered in patients with recalcitrant neuralgia after microvascular decompression and rhizotomy of the glossopharyngeal nerve.

AB - Object. Knowledge of the variations in the nerves of the posterior cranial fossa may be important during skull base approaches. To the authors' knowledge, intracranial neural interconnections between the glossopharyngeal and vagus nerves have not been previously investigated. Methods. The senior author (A.C.G.) noted the presence of an intracranial interneural connection between the glossopharyngeal and vagus nerves during microvascular decompression surgery in a patient suffering from hemifacial spasm. To further investigate the approximate incidence and significance of such an interneural connection, the authors studied 40 adult human cadavers (80 sides) and prospectively evaluated 16 additional patients during microvascular procedures of the posterior cranial fossa. Results. In the cadavers, the incidence of intracranial neural connections between the glossopharyngeal and vagus nerves was 2.5%. The only such connection found in our series of living patients was in the patient in whom the connection was initially identified. These interconnections were more common on the left side. Based on our findings, we classified these neural connections as Types I and II. In the cadavers, the length and width of this connection were approximately 9 mm and 1 mm, respectively. Histological analysis of these connections verified their neural content. Conclusions. Although these connections are rare and the significance is unknown, knowledge of them may prove useful to surgeons who operate in the posterior fossa region so that they may avoid inadvertent traction or transection of these interconnections. Additionally, such connections might be considered in patients with recalcitrant neuralgia after microvascular decompression and rhizotomy of the glossopharyngeal nerve.

KW - Anatomy

KW - Intracranial connection

KW - Neurosurgery

KW - Variation

UR - http://www.scopus.com/inward/record.url?scp=79960008345&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960008345&partnerID=8YFLogxK

U2 - 10.3171/2011.2.JNS101757

DO - 10.3171/2011.2.JNS101757

M3 - Article

VL - 115

SP - 179

EP - 181

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 1

ER -