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      <h1 class="highwire-cite-title" id="page-title">The Functions of the Nervus Intermedius</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Alfieri</span>, <span class="highwire-citation-author" data-delta="1">J. Fleischhammer</span> and <span class="highwire-citation-author" data-delta="2">J. Prell</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E144; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2624 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11410--6651221093" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Alfieri </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BAlfieri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Alfieri%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BAlfieri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. Fleischhammer </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BFleischhammer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fleischhammer%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BFleischhammer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J. Prell </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BPrell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Prell%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BPrell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view"><span class="highwire-journal-article-marker-start"></span><p id="p-1">We read with extreme interest the article written by Burmeister et al entitled “Identification of the Nervus Intermedius Using 3T MR Imaging.”<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> It is surprising that this minute nerve has gained such a wide clinical, functional, and now radiologic interest since the original description in 1778 by Wrisberg.<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup></p><p id="p-2">However, there is a point of concern in the article. The authors stated in the introduction that one of the functions of the nervus intermedius (NI) is the “sensory and parasympathetic innervation of the parotid gland.” This sentence is somewhat troubling, and we cannot agree with it.</p><p id="p-3">To our knowledge, the NI innervates the lacrimal, submandibular, and sublingual glands. The afferent component of the NI carries sensorial perception from the skin of the external auditory meatus and from the nasopharynx and nose; and taste from the anterior two- thirds of the tongue, floor of the mouth, and the palate.<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a></sup> Moreover, contemporary intraoperative electrophysiologic observations have shown an unforeseen electromyographic activity of perioral muscles after NI stimulus,<sup><a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a>,<a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a></sup> which can help in the operative recognition of the nerve and may involve the presence of a small amount of motor fibers.</p><p id="p-4">On the other hand, it is generally accepted that the parasympathetic innervation of the parotid gland originates in the inferior salivary nucleus, leaving the brain stem through the tympanic nerve, a branch of the ninth cranial nerve. From then on, the fibers convey into the lesser petrosal nerve entering the otic ganglion. The parotid gland is, thereafter, reached through the auriculotemporal nerve, a subdivision of the mandibular subdivision of the trigeminal nerve.<sup><a id="xref-ref-6-1" class="xref-bibr" href="#ref-6">6</a></sup></p><p id="p-5">In conclusion, we could not find any suggestion that the NI innervates the parotid gland directly.</p><div class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.E144.1" data-doi="10.3174/ajnr.A2338"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Burmeister</span>  <span class="cit-name-given-names">HP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Baltzer</span>  <span class="cit-name-given-names">PA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dietzel</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Identification of the nervus intermedius using 3T MR imaging</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">32</span>:<span class="cit-fpage">460</span>–<span class="cit-lpage">64</span>. <span class="cit-comment">Epub 2011 Feb 3</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIzMi8zLzQ2MCI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMi83L0UxNDQuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.E144.2" data-doi="10.1016/j.aanat.2010.02.004"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Alfieri</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Strauss</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Prell</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">History of the nervus intermedius of Wrisberg</span>. <abbr class="cit-jnl-abbrev">Ann Anat</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">192</span>:<span class="cit-fpage">139</span>–<span class="cit-lpage">44</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.aanat.2010.02.004&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20427169&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2FE144.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.E144.3" data-doi="10.1097/MAO.0b013e3181ca8711"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Gacek</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lyon</span>  <span class="cit-name-given-names">MJ</span></span></li></ol><cite>. <span class="cit-article-title">Evidence of a gustatory-vestibular pathway for protein transport</span>. <abbr class="cit-jnl-abbrev">Otol Neurotol</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">31</span>:<span class="cit-fpage">313</span>–<span class="cit-lpage">18</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/MAO.0b013e3181ca8711&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20010445&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2FE144.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.E144.4" data-doi="10.3171/JNS/2008/109/7/0144"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Scheller</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rachinger</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Prell</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Schwannoma of the intermediate nerve</span>. <abbr class="cit-jnl-abbrev">J Neurosurg</abbr> <span class="cit-pub-date">2008</span>;<span class="cit-vol">109</span>:<span class="cit-fpage">144</span>–<span class="cit-lpage">48</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.3171/JNS/2008/109/7/0144&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=18590446&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2FE144.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.7.E144.5" data-doi="10.1097/00129492-200503000-00026"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Ashram</span>  <span class="cit-name-given-names">YA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Jackler</span>  <span class="cit-name-given-names">RK</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Pitts</span>  <span class="cit-name-given-names">LH</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Intraoperative electrophysiologic identification of the nervus intermedius</span>. <abbr class="cit-jnl-abbrev">Otol Neurotol</abbr> <span class="cit-pub-date">2005</span>;<span class="cit-vol">26</span>:<span class="cit-fpage">274</span>–<span class="cit-lpage">79</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/00129492-200503000-00026&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=15793419&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F7%2FE144.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a>

<div class="cit ref-cit ref-book" id="cit-32.7.E144.6"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">May</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Shaitkin</span>  <span class="cit-name-given-names">B</span></span></li></ol><cite>. <span class="cit-source">The Facial Nerve</span>. <span class="cit-publ-loc">New York</span>: <span class="cit-publ-name">Thieme Medical Publisher</span>; <span class="cit-pub-date">2000</span></cite></div><div class="cit-extra"></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 32</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2011 </div></div>
      
      
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