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PT  - JOURNAL ARTICLE
AU  - Meng, S.
AU  - Reissig, L.F.
AU  - Tzou, C.-H.
AU  - Meng, K.
AU  - Grisold, W.
AU  - Weninger, W.
TI  - Ultrasound of the Hypoglossal Nerve in the Neck: Visualization and Initial Clinical Experience with Patients
AID  - 10.3174/ajnr.A4494
DP  - 2016 Feb 01
TA  - American Journal of Neuroradiology
PG  - 354--359
VI  - 37
IP  - 2
4099  - http://www.ajnr.org/content/37/2/354.short
4100  - http://www.ajnr.org/content/37/2/354.full
SO  - Am. J. Neuroradiol.2016 Feb 01; 37
AB  - BACKGROUND AND PURPOSE: The hypoglossal nerve, providing motor innervation for the tongue, can be affected in many diseases of the neck and skull base, leading to dysarthria, dysphagia, and ultimately atrophy of the tongue. We determined the feasibility of direct visualization of the hypoglossal nerve in the neck with ultrasound, testing this technique on healthy volunteers and evaluating it in clinical practice.MATERIALS AND METHODS: The study consisted of 4 parts: first, ultrasound-guided perineural ink injections along the course of the hypoglossal nerve at 24 sides of 12 fresh, nonembalmed cadaver necks. Subsequently, the specimens were dissected to confirm the correct identification of the nerve. The second part was examination of healthy volunteers with ultrasound and measurement of cross-sectional areas for generating reference data. The third part was scanning of healthy volunteers by 2 resident physicians with little and intermediate experience in ultrasound. Fourth was examination with ultrasound of patients with motor symptoms of the tongue.RESULTS: The hypoglossal nerve was correctly identified bilaterally in all cadaveric specimens (24/24) and all volunteers (33/33). The cross-sectional area ranged from 1.9 to 2.1 mm2. The resident physicians were able to locate the nerve in 19 of 22 cases, demonstrating that locating the nerve is reproducible and feasible even with intermediate experience in ultrasound. Finally, alterations of the hypoglossal nerve in disease states could be depicted.CONCLUSIONS: Direct, reliable, and reproducible visualization of the extracranial hypoglossal nerve with ultrasound is feasible.USultrasound