Clinical Image
Hemiatrophy of the Denervated Tongue
Yoshinori Fujita and Yoshinari Myoken*
Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Japan
*Corresponding author: Yoshinari Myoken, Hiroshima Red Cross & Atomic-bomb Survivors Hospital.Senda-machi, Naka-ku, 730- 0052, Hiroshima, Japan
Published: 27 Sep, 2017
Cite this article as: Fujita Y, Myoken Y. Hemiatrophy of the
Denervated Tongue. Clin Surg. 2017;
2: 1641.
Clinical Image
A 69-year-old woman presented with a 4-year history of dysphagia, dysarthria, and muscle
wasting of the left half of her tongue. There were no other orofacial symptoms. The patient had
undergone left marginal resection of the mandible in combination with supraomohyoid neck
dissection 6. Years earlier for a malignant tumor of the left mandible. On physical examination, the
left half of the tongue was atrophied and deviated to the left on protrusion (Figure 1). A computed
tomographic scan showed low density with atrophy of the left side of the tongue indicating the
development of fatty infiltration (Figure 2).. There was no cervical lymphadenopathy. Positron
emission computed tomographic scanning confirmed no tumor recurrence in the neck. Since the
hypoglossal nerve (twelfth cranial nerve) supplies motor innervation to the muscles of the tongue,
denervation caused by the damage to the hypoglossal nerve is manifest as hemiatrophy of the tongue.
Hypoglossal paralysis occurring after neck dissection for cervical malignancies suggests the
likelihood not only of recurrence with involvement of the hypoglossal nerve but also of postoperative
changes [1,2]. The cranial and cervical nerves are at high risk for injuries during neck dissection [3].
Figure 1
Figure 2
References
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- Junquera L, Gallego L. Denervation atrophy of the tongue after hypoglossal-nerve injury. N Engl J Med. 2012;367:156.
- Murakami R, Baba Y, Nishimura R, Furusawa M, Baba T, Okuda T, et al. CT and MR findings of denervated tongue after radical neck dissection. AJNR Am J Neuroradiol. 1997;18:747-50.